Efficacy and Safety of "Vacuum Swallowing" Based on a Strong Negative Esophageal Pressure in Healthy Individuals.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY Dysphagia Pub Date : 2024-08-17 DOI:10.1007/s00455-024-10741-y

Kenjiro Kunieda, Saori Suzuki, Satoe Naganuma, Keishi Okamoto, Tomohisa Ohno, Takashi Shigematsu, Naomi Yagi, Yoshitaka Oku, Ichiro Fujishima

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Abstract

Vacuum swallowing is a unique method for improving the pharyngeal passage of a bolus by creating subatmospheric negative pressure in the esophagus. However, whether healthy individuals and other patients with dysphagia can reproduce vacuum swallowing remains unclear. Therefore, this study aimed to assess whether healthy individuals verified using high-resolution manometry (HRM) could reproduce vacuum swallowing and evaluate its safety using a swallowing and breathing monitoring system (SBMS). Two healthy individuals who mastered vacuum swallowing taught this method to 12 healthy individuals, who performed normal and vacuum swallowing with 5 mL of water five times each. The minimum esophageal pressure and the maximum pressure of the lower esophageal sphincter (LES) were evaluated during each swallow using the HRM. Additionally, respiratory-swallowing coordination was evaluated using the SBMS. Ten individuals reproduced vacuum swallowing, and a total of 50 vacuum swallows were analyzed. The minimum esophageal pressure (-15.0 ± 4.9 vs. -46.6 ± 16.7 mmHg; P < 0.001) was significantly lower, and the maximum pressure of the LES (25.4 ± 37.7 vs. 159.5 ± 83.6 mmHg; P < 0.001) was significantly higher during vacuum swallowing. The frequencies of the I-SW and SW-I patterns in vacuum swallowing were 38.9% and 0%, respectively, using the SBMS. Vacuum swallowing could be reproduced safely in healthy participants with instruction. Therefore, instructing exhalation before and after vacuum swallowing is recommended to prevent aspiration.

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基于强大食管负压的 "真空吞咽 "对健康人的有效性和安全性

真空吞咽是一种独特的方法，可通过在食道中产生亚大气压负压来改善咽部通过栓剂的能力。然而，健康人和其他吞咽困难患者能否重现真空吞咽仍不清楚。因此，本研究旨在评估使用高分辨率测压法（HRM）验证的健康人是否能重现真空吞咽，并使用吞咽和呼吸监测系统（SBMS）评估其安全性。两名掌握了真空吞咽法的健康人向 12 名健康人传授了这一方法，他们分别用 5 毫升水进行了正常吞咽和真空吞咽 5 次。在每次吞咽过程中，使用 HRM 对食管下括约肌（LES）的最小食管压力和最大压力进行评估。此外，还使用 SBMS 评估了呼吸与吞咽的协调性。10 人重现了真空吞咽，共分析了 50 次真空吞咽。最低食管压力（-15.0 ± 4.9 vs. -46.6 ± 16.7 mmHg; P

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来源期刊

Dysphagia 医学-耳鼻喉科学

CiteScore

4.90

自引率

15.40%

发文量

149

审稿时长

6-12 weeks

期刊介绍： Dysphagia aims to serve as a voice for the benefit of the patient. The journal is devoted exclusively to swallowing and its disorders. The purpose of the journal is to provide a source of information to the flourishing dysphagia community. Over the past years, the field of dysphagia has grown rapidly, and the community of dysphagia researchers have galvanized with ambition to represent dysphagia patients. In addition to covering a myriad of disciplines in medicine and speech pathology, the following topics are also covered, but are not limited to: bio-engineering, deglutition, esophageal motility, immunology, and neuro-gastroenterology. The journal aims to foster a growing need for further dysphagia investigation, to disseminate knowledge through research, and to stimulate communication among interested professionals. The journal publishes original papers, technical and instrumental notes, letters to the editor, and review articles.