Chitose Shun-Ichi, Shin Yasuro, Sato Kiminori, Hamakawa Sachiyo, Fukahori Mioko, Ono Takeharu, Umeno Hirohito
Department of Otolaryngology-Head and Neck Surgery Kurume University School of Medicine Kurume Japan.
Laryngoscope Investig Otolaryngol. 2019 Nov 11;4(6):645-652. doi: 10.1002/lio2.324. eCollection 2019 Dec.
High-resolution manometry (HRM) is used to analyze upper esophageal sphincter (UES) physiology. Conventional HRM can yield imprecise measurements of UES resting pressure given its unidirectional sensors and averaging of circumferential pressure. In contrast, three-dimensional (3D) measurements can yield precise UES resting pressure data over the entire length of the UES. This study conducted a detailed analysis of UES resting pressure as evaluated by 3D-HRM.
Seventeen young, healthy adult participants (7 females and 10 males) were recruited. The 3D-HRM system used includes a pressure sensor catheter (outer diameter, 4 mm) and eight-channel transducers arranged circumferentially to acquire pressure data at 45° intervals. The catheter was inserted transnasally into the esophagus and automatically retracted at a speed of 1 mm/s. Participants performed the following tasks: maintain resting breathing, perform breath holding, and perform the Valsalva maneuver. Data were obtained and compared per millimeter over the longitudinal UES length.
Clear 3D waveforms were identified, with greater mean UES pressures in anterior-posterior directions than in lateral directions ( < .05). The anterior distribution was located superior to the posterior portion. Significant differences were observed in mean UES pressures and UES resting integrals between resting breathing and the Valsalva maneuver ( < 0.05). No differences in functional UES length were observed.
The normal UES resting pressure was not directionally uniform in the luminal structure. 3D-HRM imaging of UES resting pressure can help deepen our understanding of UES physiology.
高分辨率测压法（HRM）用于分析食管上括约肌（UES）的生理功能。传统的HRM由于其单向传感器和圆周压力平均值，可能会对UES静息压力产生不精确的测量结果。相比之下，三维（3D）测量可以在UES的整个长度上产生精确的UES静息压力数据。本研究对通过3D-HRM评估的UES静息压力进行了详细分析。
招募了17名年轻、健康的成年参与者（7名女性和10名男性）。所使用的3D-HRM系统包括一个压力传感器导管（外径4毫米）和沿圆周排列的八个通道换能器，以45°间隔获取压力数据。导管经鼻插入食管，并以1毫米/秒的速度自动回撤。参与者执行以下任务：保持静息呼吸、屏气和进行瓦尔萨尔瓦动作。在UES纵向长度上每毫米获取并比较数据。
识别出清晰的3D波形，前后方向的平均UES压力大于左右方向（<0.05）。前部分布位于后部上方。静息呼吸和瓦尔萨尔瓦动作之间的平均UES压力和UES静息积分存在显著差异（<0.05）。未观察到功能性UES长度的差异。
正常UES静息压力在管腔结构中并非各向均匀。UES静息压力的3D-HRM成像有助于加深我们对UES生理学的理解。
4级。
