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A less invasive surgical technique established for functional disorder of upper esophageal sphincter using 3D high resolution manometry

Research Project

Project/Area Number 16K11250
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Otorhinolaryngology
Research InstitutionKurume University

Principal Investigator

Shun-ichi Chitose  久留米大学, 医学部, 准教授 (20299514)

Co-Investigator(Kenkyū-buntansha) 進 保朗  久留米大学, 医学部, 助教 (40569357)
深堀 光緒子  久留米大学, 医学部, 助教 (50529310)
梅野 博仁  久留米大学, 医学部, 教授 (40203583)
佐藤 公則  久留米大学, 医学部, 客員教授 (70196228)
Project Period (FY) 2016-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2017: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2016: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
Keywords食道入口部 / 輪状咽頭筋 / 嚥下 / 嚥下障害 / 高解像度マノメトリー / 三次元画像 / 輪状咽頭筋切断術 / 低侵襲手術 / 内視鏡下輪状咽頭筋切断術 / 機能不全 / 手術適応
Outline of Final Research Achievements

Objective: Conventional high resolution manometry (HRM) can provide imprecise measurement of UES resting pressure.This study conducted a detailed analysis of UES resting pressure using 3D-HRM for evaluation. Methods: Seventeen young healthy adult participants were recruited.The 3D-HRM system had a pressure sensor catheter and eight channel transducers arranged circumferentially to acquire 45°.The catheter was transnasally inserted into the esophagus then automatically retracted at a speed of 1 mm/sec.Participants maintained resting breathing,breath holding,Valsalva maneuvers. Results: Mean UES pressures as identified clear 3-dimensional waveforms were greater in anterior and posterior portions than in lateral portions (p<0.05). Significant differences were observed in mean UES pressures and UES resting integrals between resting breathing and Valsalva maneuvers (p<0.05). Conclusion: 3-dimensional HRM imaging of UES resting pressure could provide further understanding of UES physiology.

Academic Significance and Societal Importance of the Research Achievements

食道における生理的第一狭窄部である食道入口部は、安静時に一定の圧力をもって閉鎖している。同部の括約機構の機能不全に伴う嚥下障害に対しては、輪状咽頭筋切断術が最も有効な治療手段になる。しかし、これまで手術適応を決定するための定量化された指標はなく、合理的な筋切断あるいは切除法も確立していなかった。本研究で行った3D-HRMを用いた食道入口部の静止圧測定は、輪状咽頭筋の切断(切除)部位の術前確認および手術効果の定量評価に対して、安定的な記録が行えるものと考えられる。

Report

(4 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (16 results)

All 2019 2018 2017 2016

All Journal Article (5 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 1 results,  Open Access: 1 results) Presentation (10 results) (of which Int'l Joint Research: 3 results,  Invited: 5 results) Book (1 results)

  • [Journal Article] 外科的治療を勧める際の注意点2019

    • Author(s)
      千年俊一
    • Journal Title

      JOHNS

      Volume: 35 Pages: 371-374

    • Related Report
      2018 Annual Research Report
  • [Journal Article] 輪状咽頭筋切断術・喉頭挙上術を行う前に. 患者家族への説明ガイド2018

    • Author(s)
      千年俊一
    • Journal Title

      耳喉頭頸

      Volume: 90 Pages: 238-239

    • Related Report
      2018 Annual Research Report
  • [Journal Article] 嚥下障害に対する新たな低侵襲アプローチ法. -炭酸ガスレーザーによる内視鏡下輪状咽頭筋切断術-2018

    • Author(s)
      千年俊一
    • Journal Title

      光アライアンス

      Volume: 29 Pages: 40-43

    • Related Report
      2018 Annual Research Report
  • [Journal Article] 他科から嚥下評価の依頼を受けたとき. -基本的な評価方法と指導-.2018

    • Author(s)
      千年俊一
    • Journal Title

      MB ENT

      Volume: 223 Pages: 103-107

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Endoscopic surgical technique for benign fibrotic strictures of the upper esophageal sphincter2017

    • Author(s)
      Shun-ichi Chitose, Kiminori Sato, Mioko Fukahori, Sachiyo Hamakawa, Akari Koga, Shintaro Sueyoshi、Hirohito Umeno
    • Journal Title

      Digestive Endoscopy

      Volume: 29 Issue: 7 Pages: 806-810

    • DOI

      10.1111/den.12927

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] “Novel clues for diagnosis and therapy of dysphagia” A new paradigm for endoscopic cricopharyngeal myotomy. -Techniques for managing surgical complications-2018

    • Author(s)
      Shun-ichi Chitose
    • Organizer
      The 20th World Congress for Bronchoesophagology
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Lateral pharyngeal flap with a double pedicle for repair of unilateral velopharyngeal insufficiency2018

    • Author(s)
      Shun-ichi Chitose
    • Organizer
      The 139th Annual Meeting of the American Broncho-Esophagological Association
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 3次元高解像度マノメトリーによる内視鏡下輪状咽頭筋切断術の適応基準と合理的手技の確立.2018

    • Author(s)
      千年俊一
    • Organizer
      第63回日本音声言語医学会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] 頭頸部鏡視下手術の新技術」 経口内視鏡下輪状咽頭筋切断術 -術中・術後合併症への対応と対策-2018

    • Author(s)
      千年俊一
    • Organizer
      第29回 日本頭頸部外科学会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] 3D高解像度マノメトリーを用いた上部食道括約機構の解析2017

    • Author(s)
      進 保朗
    • Organizer
      第40回 日本嚥下医学会
    • Place of Presentation
      東京
    • Year and Date
      2017-02-24
    • Related Report
      2016 Research-status Report
  • [Presentation] 内視鏡下輪状咽頭筋切断術2017

    • Author(s)
      千年 俊一
    • Organizer
      第29回日本喉頭科学会
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] 経口的嚥下機能改善手術の適応と治療効果2017

    • Author(s)
      千年 俊一
    • Organizer
      第27回日本気管食道科専門医大会
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] 3D Imaging of Upper Esophageal Sphincter Resting Pressure2017

    • Author(s)
      Shun-ichi Chitose
    • Organizer
      AAO-HNSF Annual Meeting & OTO Experience 2017
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] 3D高解像度マノメトリーによる食道入口部の機能評価2016

    • Author(s)
      進 保朗
    • Organizer
      第68回 日本気管食道科学会
    • Place of Presentation
      東京
    • Year and Date
      2016-11-17
    • Related Report
      2016 Research-status Report
  • [Presentation] 3D高解像度マノメトリーを用いた輪状咽頭筋切断術の適応決定法の考案2016

    • Author(s)
      千年 俊一
    • Organizer
      第68回 日本気管食道科学会
    • Place of Presentation
      東京
    • Year and Date
      2016-11-17
    • Related Report
      2016 Research-status Report
  • [Book] 医歯薬出版2018

    • Author(s)
      千年俊一
    • Total Pages
      6
    • Publisher
      経口的嚥下機能改善手術. 耳鼻咽喉科診療の進歩 40のエッセンス
    • ISBN
      9784263206799
    • Related Report
      2018 Annual Research Report

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Published: 2016-04-21   Modified: 2020-03-30  

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