The effect of lateral shift of cricoid cartilage on pharyngeal swallowing.
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.
Inokuchi
Nobuhiro
N
Department of Gerodontology, Division of Gerontology and Gerodontology, Graduate School, Tokyo Medical, Tokyo, 113-8549, Japan. ingerd@tmd.ac.jp
Tohara
Haruka
H
Uematsu
Hiroshi
H
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
Anaesthesia. 1992 Feb;47(2):95-100
1539807
AJR Am J Roentgenol. 1993 May;160(5):1005-9
8470567
J Neurophysiol. 1956 Jan;19(1):44-60
13286721
Lancet. 1979 Aug 4;2(8136):228-30
89335
Int J Obstet Anesth. 1992 Sep;1(4):195-8
15636825
Int J Obstet Anesth. 1994 Jul;3(3):143-5
15636937
Otolaryngol Head Neck Surg. 1994 Feb;110(2):222-7
8108157
Arch Phys Med Rehabil. 1993 Feb;74(2):178-81
8431103
Dysphagia. 1993;8(1):1-6
8436016
Lancet. 1961 Aug 19;2(7199):404-6
13749923
Anaesthesia. 1992 Sep;47(9):732-5
1415968
Anesth Analg. 2001 Sep;93(3):787-90
11524357
Arch Phys Med Rehabil. 1993 Jul;74(7):736-9
8328896
Anaesthesia. 1999 Jan;54(1):1-3
10209362
Ann Otol Rhinol Laryngol. 1998 Apr;107(4):344-8
9557771
Anaesthesia. 1991 Jan;46(1):40-1
1996754
Acta Radiol Diagn (Stockh). 1986 Nov-Dec;27(6):691-6
3812018
Neurology. 1988 Sep;38(9):1359-62
3412582
Arch Phys Med Rehabil. 2001 Sep;82(9):1255-60
11552200
Arch Phys Med Rehabil. 1989 Oct;70(10):767-71
2802957