Ann Rehabil Med.  2015 Jun;39(3):425-431. 10.5535/arm.2015.39.3.425.

Effects of Head Rotation and Head Tilt on Pharyngeal Pressure Events Using High Resolution Manometry

• Kim CK
• Ryu JS
• Song SH
• Koo JH
• Lee KD
• Park HS
• Oh Y
• Min K

• KMID: 2165646
• DOI: http://doi.org/10.5535/arm.2015.39.3.425

Abstract

OBJECTIVE
To observe changes in pharyngeal pressure during the swallowing process according to postures in normal individuals using high-resolution manometry (HRM).
METHODS
Ten healthy volunteers drank 5 mL of water twice while sitting in a neutral posture. Thereafter, they drank the same amount of water twice in the head rotation and head tilting postures. The pressure and time during the deglutition process for each posture were measured with HRM. The data obtained for these two postures were compared with those obtained from the neutral posture.
RESULTS
The maximum pressure, area, rise time, and duration in velopharynx (VP) and tongue base (TB) were not affected by changes in posture. In comparison, the maximum pressure and the pre-upper esophageal sphincter (UES) maximum pressure of the lower pharynx in the counter-catheter head rotation posture were lower than those in the neutral posture. The lower pharynx pressure in the catheter head tilting posture was higher than that in the counter-catheter head tilting. The changes in the VP peak and epiglottis, VP and TB peaks, and the VP onset and post-UES time intervals were significant in head tilting and head rotation toward the catheter postures, as compared with neutral posture.
CONCLUSION
The pharyngeal pressure and time parameter analysis using HRM determined the availability of head rotation as a compensatory technique for safe swallowing. Tilting the head smoothes the progress of food by increasing the pressure in the pharynx.

Keyword

Upper esophageal sphincter; Manometry; Pressure; Deglutition disorders

MeSH Terms

Catheters
Deglutition
Deglutition Disorders
Epiglottis
Esophageal Sphincter, Upper
Head*
Healthy Volunteers
Manometry*
Pharynx
Posture
Tongue
Water
Water

Figure

• 

  Fig. 1 The epiglottic tilting peak at 1 level higher or lower to epiglottis level as a tongue base pressure (A), low pharyngeal peristaltic shallow and peristaltic peak between TB and UES (B), pre-UES peak (C), and post-UES peak (D). TB, tongue base; UES, upper esophageal sphincter.

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