title: The effect of lateral shift of cricoid cartilage on pharyngeal swallowing.
abstract: Head rotation is widely used as one of the postural techniques for dysphagic patients. However, it cannot be used for patients with severe limitations to the range of motion of the neck. The purpose of this study was to determine the effect of applying pressure to the cricoid while swallowing and to explore the possibility of this maneuver as an alternative to head rotation. The swallowing function of 12 volunteers was examined with videofluorography under nine conditions: neutral, head rotated to the right, head rotated to the left, applying pressure to the cricoid on the right side at 5, 10, and 15 N, and applying pressure to the cricoid on the left side at 5, 10, and 15 N. To examine the effect of this maneuver on pharyngeal swallowing, the laterality of bolus flow was evaluated using 3 ml barium thin liquid from the posterior-anterior (P-A) view. The "pressing-cricoid" maneuver significantly altered the laterality of the bolus flow; the bolus flow was shifted to the side opposite to which the pressure was applied. The results of these changes were similar to those achieved with head rotation. These results demonstrated that the "pressing-cricoid" maneuver changes the bolus flow. This maneuver may have therapeutic value for the treatment of dysphagic patients as an alternative to head rotation.
authors.affiliation: Department of Gerodontology, Division of Gerontology and Gerodontology, Graduate School, Tokyo Medical, Tokyo, 113-8549, Japan. ingerd@tmd.ac.jp
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Inokuchi
authors.forename: Haruka
authors.initials: H
authors.lastname: Tohara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uematsu
mesh_terms: D000328:Adult; D003413:Cricoid Cartilage / Q000502:physiology*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology; D010614:Pharynx / Q000502:physiology; D011187:Posture; D014741:Video Recording; D014743:Videotape Recording
references.citation: Anaesthesia. 1992 Feb;47(2):95-100
references.pmid: 1539807
references.citation: AJR Am J Roentgenol. 1993 May;160(5):1005-9
references.pmid: 8470567
references.citation: J Neurophysiol. 1956 Jan;19(1):44-60
references.pmid: 13286721
references.citation: Lancet. 1979 Aug 4;2(8136):228-30
references.pmid: 89335
references.citation: Int J Obstet Anesth. 1992 Sep;1(4):195-8
references.pmid: 15636825
references.citation: Int J Obstet Anesth. 1994 Jul;3(3):143-5
references.pmid: 15636937
references.citation: Otolaryngol Head Neck Surg. 1994 Feb;110(2):222-7
references.pmid: 8108157
references.citation: Arch Phys Med Rehabil. 1993 Feb;74(2):178-81
references.pmid: 8431103
references.citation: Dysphagia. 1993;8(1):1-6
references.pmid: 8436016
references.citation: Lancet. 1961 Aug 19;2(7199):404-6
references.pmid: 13749923
references.citation: Anaesthesia. 1992 Sep;47(9):732-5
references.pmid: 1415968
references.citation: Anesth Analg. 2001 Sep;93(3):787-90
references.pmid: 11524357
references.citation: Arch Phys Med Rehabil. 1993 Jul;74(7):736-9
references.pmid: 8328896
references.citation: Anaesthesia. 1999 Jan;54(1):1-3
references.pmid: 10209362
references.citation: Ann Otol Rhinol Laryngol. 1998 Apr;107(4):344-8
references.pmid: 9557771
references.citation: Anaesthesia. 1991 Jan;46(1):40-1
references.pmid: 1996754
references.citation: Acta Radiol Diagn (Stockh). 1986 Nov-Dec;27(6):691-6
references.pmid: 3812018
references.citation: Neurology. 1988 Sep;38(9):1359-62
references.pmid: 3412582
references.citation: Arch Phys Med Rehabil. 2001 Sep;82(9):1255-60
references.pmid: 11552200
references.citation: Arch Phys Med Rehabil. 1989 Oct;70(10):767-71
references.pmid: 2802957