Pathophysiological evaluation by high resolution manometry and swallowing computed tomography scan, elucidation of food texture properties

2020 Fiscal Year Final Research Report

• Project/Area Number: 16KT0190
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 特設分野
• Research Field: Complex Systems Disease Theory
• Research Institution: The University of Tokyo
• Principal Investigator: Ueha Rumi 東京大学, 医学部附属病院, 准教授 (10597131)
• Project Period (FY): 2016-07-19 – 2021-03-31
• Keywords: 嚥下障害 / 食品テクスチャー / 高解像度内圧計 / 嚥下CT / バーチャルリアリティー

Outline of Final Research Achievements

In this study, we found as follows; 1) many factors that affect food texture properties were identified by examining them from the perspective of food science. It is necessary to understand the characteristics of each gelling agent before clinical use. 2) Using high-resolution pharyngo-esophageal manometry (HRM), new clinical findings were found. It was useful in elucidating the mechanisms of changes in pharyngeal pressure and upper esophageal sphincter dynamics especially in neuromuscular diseases. We demonstrated the importance of HRM in the selection of aspiration prevention surgeries. 3) In swallowing CT, four-dimensional swallowing dynamics are visualized by reconstructing sequential images using dedicated software. Dynamic images have the advantage of being very impactful and facilitating the understanding of three-dimensional structural changes. It is anticipated that VR technology will be widely used in swallowing examinations in the future.

Free Research Field

嚥下

Academic Significance and Societal Importance of the Research Achievements

本研究では、増粘多糖類が様々な特性を示すことを実証した。つまり、嚥下診療に関わる従事者は，患者の嚥下機能に応じた栄養指導や嚥下指導を行う際，ゲル化剤やとろみ調整食品などの増粘多糖類の性質を把握したうえで行うべきである．さらに嚥下内視鏡検査や嚥下造影検査といった一般的な嚥下機能検査だけでなく、高解像度内圧検査や嚥下CTなどの新規検査を導入することで、これまで病態把握が難しかった疾患や病態を把握しやすくなり、さらにバーチャルリアリティーを導入することで、嚥下動態の立体的な把握が可能となるなど有用性を示した．