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Tytuł:
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The effect of a chin-down maneuver after esophagectomy on oropharyngeal swallowing pressure measured using high-resolution manometry.
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Autorzy:
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Matsubara K; Department of Rehabilitations, Kumamoto Health Science University, Kumamoto, Japan.
Kumai Y; Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan. Electronic address: .
Miyamoto T; Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan.
Samejima Y; Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan.
Yoshida N; Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medicine, Japan.
Baba H; Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medicine, Japan.
Orita Y; Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan.
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Źródło:
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Auris, nasus, larynx [Auris Nasus Larynx] 2020 Feb; Vol. 47 (1), pp. 141-147. Date of Electronic Publication: 2019 Jun 14.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Amsterdam : Elsevier Science
Original Publication: Tokyo, Society for Promotion of International Otorhinolaryngology.
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MeSH Terms:
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Chin*
Esophagectomy*
Manometry*
Patient Positioning*
Pressure*
Deglutition Disorders/*physiopathology
Esophageal Neoplasms/*surgery
Postoperative Complications/*physiopathology
Aged ; Deglutition ; Esophageal Sphincter, Upper ; Female ; Humans ; Hypopharynx ; Lymph Node Excision ; Male ; Middle Aged ; Palate, Soft ; Pharynx ; Posture ; Plastic Surgery Procedures ; Vocal Cord Paralysis/physiopathology
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Contributed Indexing:
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Keywords: Chin-down position; Esophagectomy; High-resolution manometry; Swallowing dysfunction; Swallowing pressure; Three-field lymph node dissection; Upper esophageal sphincter
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Entry Date(s):
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Date Created: 20190618 Date Completed: 20201201 Latest Revision: 20221207
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Update Code:
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20240105
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DOI:
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10.1016/j.anl.2019.06.001
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PMID:
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31204048
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Objective: To elucidate the effects of a chin-down maneuver using high-resolution manometry (HRM) to measure pharyngeal swallowing pressure (SP) after esophagectomy.
Methods: We evaluated 9 of 16 patients who underwent esophagectomy featuring gastric tube reconstruction and three-field lymph node dissection (3FL) in our Department of Gastroenterological Surgery from September 2015 to June 2016. We compared all parameters of the neutral and chin-down positions using HRM to measure the maximum SP at the velopharynx, meso-hypopharynx, and upper esophageal sphincter (UES) and the duration of lowered SP at the UES, the distance from nostrils to the boundary between hypopharynx and UES and to derive SP and SP propagation curves at various distances from the nostrils.
Results: Compared to that at the neutral position, the maximum SP at the velopharynx was significantly lower in the chin-down position (p<0.05); however, SP at the meso-hypopharynx and UES did not differ significantly. The duration of lowered SP at the UES was significantly prolonged in the chin-down position and the distance from nostrils to the boundary between hypopharynx and UES was significantly shortened representing the elevation of the larynx, respectively (p<0.05, p<0.01). On the SP propagation curve for males, the times to SP peaks at 13, 16, 17, and 18cm from the nostrils were significantly prolonged (all p<0.05) in the chin-down position.
Conclusion: Chin-down positioning after esophagectomy/3FL may improve bolus passage by prolonging the duration of lowered SP at the UES, possibly by enhancing laryngeal elevation.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
