title: Effects of Head Rotation and Head Tilt on Pharyngeal Pressure Events Using High Resolution Manometry.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Cheol Ki
authors.initials: CK
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Ju Seok
authors.initials: JS
authors.lastname: Ryu
authors.affiliation: Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Sun Hong
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Jung Hoi
authors.initials: JH
authors.lastname: Koo
authors.affiliation: Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Kyung Duck
authors.initials: KD
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
authors.forename: Hee Sun
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Yoongul
authors.initials: Y
authors.lastname: Oh
authors.affiliation: Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Kyunghoon
authors.initials: K
authors.lastname: Min
keywords: Deglutition disorders; Manometry; Pressure; Upper esophageal sphincter