Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan.
Otolaryngol Head Neck Surg. 2010 Feb;142(2):214-7. doi: 10.1016/j.otohns.2009.10.033.
This study aimed to quantify the effects of head rotation on upper esophageal sphincter (UES) pressure in healthy subjects using a novel high-resolution manometry (HRM) system.
Prospective study.
Nagasaki University Hospital.
Eighteen asymptomatic Japanese male adult volunteers were studied. A solid-state HRM was positioned to record resting UES pressure. After endoscopically confirming on which side of the pyriform sinus the manometric sensor was positioned within the hypopharynx, we measured the maximum and mean values of the resting UES pressure and the length of the zone of the UES along the esophagus with the patients in the following positions: 1) neutral and straightforward head position (NSF), 2) turning the head in the direction of the side in which the sensor was positioned (HSS), and 3) turning the head in the opposite direction of the side with sensor (HOS).
The maximum and mean values of the resting UES pressure were statistically higher in HSS than in NSF (P = 0.0001 and P < 0.0001, respectively), and were statistically lower in HOS than in NSF (P < 0.0001 and P < 0.0001, respectively). The length of the zone of the UES was statistically shorter in HOS than in NSF (P < 0.0001), but there was no significant difference in resting UES pressure along the esophagus between HSS and NSF (P = 0.3024).
The present study provided us with physiological information regarding normal UES pressure in relation to head rotation. This data will be of aid to future clinical and investigative swallowing studies. Additionally, the current study provides evidence of the safety and usefulness of the head rotation maneuver for dysphagic patients.
本研究旨在使用新型高分辨率测压法（HRM）系统定量研究健康受试者头部旋转对上食管括约肌（UES）压力的影响。
前瞻性研究。
长崎大学医院。
研究了 18 名无症状的日本成年男性志愿者。将固态 HRM 置于记录静止时UES 压力的位置。在内镜下确认测压传感器在咽的梨状隐窝内位于哪一侧后，我们让患者处于以下位置，测量静止时UES 压力的最大值和平均值以及UES 沿食管的长度：1）中立正直头位（NSF），2）将头转向传感器所在侧（HSS），3）将头转向传感器对侧（HOS）。
HSS 时静止时UES 压力的最大值和平均值均显著高于 NSF（P = 0.0001 和 P < 0.0001），HOS 时显著低于 NSF（P < 0.0001 和 P < 0.0001）。HOS 时UES 长度显著短于 NSF（P < 0.0001），但 HSS 时与 NSF 时UES 沿食管的静止压力无显著差异（P = 0.3024）。
本研究提供了有关正常UES 压力与头部旋转之间关系的生理学信息。这些数据将有助于未来的临床和研究吞咽研究。此外，本研究为吞咽困难患者头部旋转操作的安全性和有效性提供了证据。
