2018 Fiscal Year Final Research Report
A less invasive surgical technique established for functional disorder of upper esophageal sphincter using 3D high resolution manometry
| Project/Area Number |
16K11250
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Kurume University |
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Principal Investigator |
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| 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)
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Keywords | 食道入口部 / 輪状咽頭筋 / 嚥下 / 嚥下障害 |
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| 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.
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| Free Research Field |
耳鼻咽喉科・頭頸部外科
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| 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。
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