Study of Normal Swallowing by Simultaneous Video Recording of Fluoroscopy and Manometry.
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概要
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A quantitative analysis of the pharyngeal phase of swallowing was performed by simultaneous video recording of fluoroscopy and manometry on 32 asymptomatic young adult volunteers (16 males 16 females). Pressure changes were measured by an intraluminal manometric probe, outer diameter 3.0 mm, inserted into the cervical esophagus via the nose. Three radiopaque microsensors, spaced at 4 cm intervals and oriented posteriorly, recorded pressure changes from the oropharynx, hypopharynx and upper esophageal sphincter (UES). Motion pictures of the videotapes were bed into a personal computer, and laryngeal movement was measured horizontaly and verticaly. Oropharyngeal manometry revealed high intrabolus pressure, whereas hypopharyngeal manometry showed low intrabolus pressure except for the bolus tail passage. A correlation analysis revealed that there were significant increases in UES relaxation time with increasing UES transit time (r=0.72, p<0.0001). The rapidly ascending movement of larynx started significantly early, compared to the rapid forward movement (p=0.0001). UES pressure descended with the rapid forward movement of the larynx, and the minimum pressure (negative values in 22 cases) occurs immediately prior to the arrival of the bolus at the piriform sinus. Our study suggests that oropharyngeal pressure drives the bolus and not only minimizes pharyngeal residue after swallowing, and that the two directions of the laryngeal movement have different functions, first the ascending movement protects the airway by tilting the epiglottis. The forward movement decreases the UES pressure to enable the passage of the bolus.
- 特定非営利活動法人 日本気管食道科学会の論文
特定非営利活動法人 日本気管食道科学会 | 論文
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