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.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.anl.2019.06.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
User-centred design, validation and clinical testing of an anti-choking mug for people with Parkinson's disease.
Sci Rep
June 2024
Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330, Thailand.
Oropharyngeal dysphagia, or difficulty initiating swallowing, is a frequent problem in people with Parkinson's disease (PD) and can lead to aspiration pneumonia. The efficacy of pharmacological options is limited. Postural strategies, such as a chin-down manoeuvre when drinking, have had some degree of success but may be difficult for people who have other limitations such as dementia or neck rigidity, to reproduce consistently.
View Article and Find Full Text PDFThe effectiveness of chin-down manoeuvre in patients with dysphagia: A systematic review and meta-analysis.
J Oral Rehabil
April 2024
School of Nursing, Nanjing Medical University, Nanjing, China.
Aim: The chin-down posture is a widely used compensatory manoeuvre for patients with dysphagia. The aim of this study was designed to systematically measure the effectiveness of chin-down manoeuvre application.
Methodology: We retrieved the PubMed, Web of Science, Embase, Cochrane Library, EBSCO, Medline, CNKI, WANFANG, VIP and SinoMed databases from inception to 30 August 2022.
Article Synopsis
- The relationship between esophagectomy, dysphagia, and sarcopenia in esophageal cancer patients is complex and not fully understood.
- Dysphagia in these patients can stem from various factors including age, disease characteristics, and complications following surgery, with a significant number experiencing sarcopenic dysphagia linked to overall muscle loss.
- To reduce the risk of postoperative complications like dysphagia and pneumonia, it's crucial to implement a range of preoperative and postoperative interventions, including physical exercises, nutritional support, and techniques like the chin-down maneuver, involving a team of healthcare professionals.
Effects of head flexion posture in patients with dysphagia.
J Oral Rehabil
June 2022
Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.
Background: The chin-down posture is often used as a compensatory manoeuvre for patients with dysphagia. This posture presumably involves flexion of the head and/or neck, but this is not clearly defined.
Objective: This study aimed to assess the effects of head flexion posture in a retrospective study of videofluoroscopic examination of swallowing (VF).
Different types of dysphagia alleviated by the chin-down position.
Auris Nasus Larynx
October 2021
Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto Japan.
Objective: Retrospective videofluoroscopic swallowing study (VFSS) evaluations of pharyngeal swallowing were used to evaluate the types of dysphagia alleviated by the chin-down maneuver.
Materials And Methods: The study population consisted of 64 patients who underwent VFSS evaluations during neutral and chin-down maneuvers presenting specifically penetration or aspiration. The assessment of the VFSS movie clips of each maneuver was performed using parameters of the Modified Barium Swallow Impairment Profile (MBSImP) and the presence and degree of airway invasion(PDAI) by three blinded raters in the following five subcategorized groups, 1.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!