Pharynx and oesophagus evaluation during the swallow using helical computerized tomography

Takehara, Itaru; Chu, Jennifer

doi:10.1080/09638280410001704322

Cited by 10 publications

(14 citation statements)

References 8 publications

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“…Ohmae et al 13 also demonstrated that head rotation results in lateralization of the bolus. Moreover, Takehara and Chu 19 reported that head rotation closes the piriform sinus on the rotated side, causing food to fl ow down the opposite side of the pharynx.…”

Section: Comparison Between Head-on and Head-rotated Viewsmentioning

confidence: 98%

“…However, the lower piriform sinus did not respond in the same manner. This notion that the piriform sinuses close upon rotation is based on data collected via videofl uoroscopy 11 and endoscopy; 19 therefore, these previous studies were not able to observe the lower piriform sinus directly. Our results suggest that the upper piriform sinuses play a more important role in food fl ow, whereas the lower piriform sinuses do not show the same degree of morphological change.…”

Section: Comparison Between Head-on and Head-rotated Viewsmentioning

confidence: 99%

“…To observe the piriform sinuses in three dimensions, diagnostic imaging modalities that produce sectional images are required. [17][18][19] The majority of 3-D imaging modalities, such as conventional CT or magnetic resonance imaging (MRI), are designed to examine patients in the supine position. However, the morphology of the piriform sinuses of patients in the supine position differs from that in patients in the normal, seated eating posture.…”

Section: Introductionmentioning

confidence: 99%

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A morphological comparison of the piriform sinuses in head-on and head-rotated views of seated subjects using cone-beam computed tomography

et al. 2008

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A morphological comparison of the piriform sinuses in head-on and headrotated views of seated subjects using cone-beam computed tomography Abstract Objectives. Food fl ow in the oropharynx changes when the head is rotated. The purpose of this study was to evaluate morphological differences in the upper and lower piriform sinuses in head-on (HO) versus head-rotated (HR) positions. Methods. Ten healthy adult volunteers with no previous history of dysphagia were subjected to cone-beam computed tomography (CBCT) in the HO and HR positions. Binary CBCT images were created at 50% gray scale to examine morphological changes in the lower piriform sinuses. Results. Upon rotation to the right, the cross-sectional area of the left lower piriform sinus increased signifi cantly (P = 0.037). The depth of the right lower piriform sinus also increased signifi cantly (P = 0.011) upon rotation. The volume of the lower piriform sinuses increased signifi cantly on both sides (right, P = 0.009; left, P = 0.013). The upper piriform sinuses acquired a teardrop shape, with the rotated side narrowed and opposite side enlarged. Conclusions. These results suggest that changes in food fl ow during head rotation result mainly from changes in the size and shape of the upper piriform sinuses.

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Section: Comparison Between Head-on and Head-rotated Viewsmentioning

confidence: 98%

Section: Comparison Between Head-on and Head-rotated Viewsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A morphological comparison of the piriform sinuses in head-on and head-rotated views of seated subjects using cone-beam computed tomography

et al. 2008

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“…Imaging of the closure of the hemipharynx with head rotation [16] and swallowing analysis using a single-slice cine mode [17] have also been reported. However, in these techniques, scanning is carried out with the subject in the supine position and the analysis involves only axial images.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Swallowing Using 320-Detector-Row Multislice CT. Part I: Single- and Multiphase Volume Scanning for Three-dimensional Morphological and Kinematic Analysis

et al. 2010

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A 320-detector-row multislice computed tomography (320-MSCT) scanner can acquire a volume data set covering a maximum range of 16 cm and can generate axial images 0.5-mm thick at 0.5-mm intervals. Three-dimensional (3D) images reconstructed from the thin axial slices include multiplanar reconstruction and 3D-CT. Single-phase 3D images are reconstructed from 0.175-s data, and multiphase 3D images are created in 29 phases at intervals of 0.1 s. Continuous replay of these 3D images produces four-dimensional moving images. In order to determine the feasibility of the morphologic and kinematic analyses of swallowing using 320-MSCT, single-phase volume scanning was performed on three patients and multiphase volume scanning was performed on one healthy volunteer. The single-phase 3D images clearly and accurately showed the structures involved in swallowing, and the multiphase 3D images were able to show the oral stage to the early esophageal stage of swallowing, allowing a kinematic analysis of swallowing. We developed a reclining chair that allows scanning to be performed with the subject in a semisitting position, which makes swallowing evaluation by 320-MSCT applicable not only to research on healthy swallowing but also to the clinical examination of dysphagia patients.

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“…Previous studies using VFSS and a manometer demonstrated that head rotation lateralizes the bolus away from the direction of head rotation and reduces upper esophageal sphincter pressure [1][2][3]. Several studies using CT and endoscopy have demonstrated morphologic change of the lower pharynx in the head-rotated posture [4][5][6][7][8]. Takasaki et al [4,5] observed the piriform sinuses using an endoscope and stated that head rotation may cause changes in the anatomical relationship between the laryngeal cartilages and the hypopharyngeal wall, resulting in differences in the size of the piriform sinus between the 2 sides.…”

Section: Discussionmentioning

confidence: 99%

Effect of head rotation on the pathway of a food bolus through the pharynx as evaluated by a videofluoroscopic swallow study

2010

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Purposes Head rotation is widely used as a postural technique for dysphagic patients. In this study, we evaluated the effects of head rotation on pharyngeal swallowing in healthy subjects. Methods A videofluoroscopic swallow study (VFSS) of pharyngeal swallowing was performed on subjects with the head in neutral (upright and full-faced) and rotated positions. Seventeen volunteers were given samples of liquid barium and custard pudding mixed with barium to swallow. Results VFSS findings revealed that the head-rotated swallow causes the bolus to lateralize away from the direction of head rotation. Satisfactory lateralization of the food or liquid bolus during a head-rotated swallow was observed in approximately 80% of cases with liquid barium and in 60% of those with material of pudding consistency. A spillage of bolus into the pharynx before swallow initiation occurred in only approximately 15% of cases when a subject rotated his/her head. Conclusion In this study, the effects of head rotation on pharyngeal swallowing in healthy subjects were evaluated. Results from this study suggest that the efficacy of head rotation is affected by the consistency of food and liquid materials.

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Pharynx and oesophagus evaluation during the swallow using helical computerized tomography

Abstract: This study shows that HCT enables visualization of TP of PES complementing VF or endoscopic swallowing studies.

Cited by 10 publications

References 8 publications

A morphological comparison of the piriform sinuses in head-on and head-rotated views of seated subjects using cone-beam computed tomography

A morphological comparison of the piriform sinuses in head-on and head-rotated views of seated subjects using cone-beam computed tomography

Evaluation of Swallowing Using 320-Detector-Row Multislice CT. Part I: Single- and Multiphase Volume Scanning for Three-dimensional Morphological and Kinematic Analysis

Effect of head rotation on the pathway of a food bolus through the pharynx as evaluated by a videofluoroscopic swallow study

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