Kaori Enatsu

Investigation of Pharyngeal Swallowing Function Using High-Resolution Manometry

Objectives/Hypothesis: This study aimed to demonstrate the feasibility of a novel high‐resolution manometry system, and to establish normal values of swallowing pressures along the velopharynx and upper esophagus.

Measurement of angle and length of the eustachian tube on computed tomography using the multiplanar reconstruction technique

Objective: To compare the anatomic features of the eustachian tube (ET) between children with and without otitis media with effusion (OME) and with adults.

Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry.

Objective: This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing using a novel high-resolution manometry (HRM) system. Study Design: Case series with planned data collection. Materials and Methods: Thirty-three asymptomatic Japanese adults were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1-cm apart was positioned to record pressures from the velopharynx to the upper esophagus at rest and during swallowing. The maximum values of the dry swallowing pressures at the velopharynx, mesohypopharynx, upper esophageal sphincter (UES), and distance from the nostril to each point of maximum values with and without the THM were measured. Results: The distance from the nostril to the UES was statistically shorter when swallowing with the THM than without the THM (paired t test, P = 0.009). The maximum pressure at UES was greater when swallowing with the THM than without the THM, although there was no statistically significant difference (paired t test, P = 0.051). There was no difference in the pressures and the distance between swallowing with or without the THM at any other site. Conclusions: These findings suggest that the THM may not have a potential to facilitate compensatory swallowing power when swallowing.

Surgical anatomy of the sphenoid sinus on the CT using multiplanar reconstruction technique

OBJECTIVE: To clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures as are relevant to performing an endoscopic sphenoidotomy. METHODS: Various dimensions of 224 CT images of the sphenoid sinus and surrounding structures from 122 Japanese adult patients were measured using the multiplanar reconstruction technique. RESULTS: The mean distance from the nasal sill to the sphenoid ostium was nearly 66 mm, and that from the sphenoid ostium to the posterior wall of the sphenoid sinus was nearly 14 mm. The angles from the sphenoid ostium to both the carotid artery and the optic canal varied among the patients. The sphenoid ostium was located at almost the vertical midpoint of the anterior wall of the sphenoid sinus. CONCLUSION: The present study provides anatomical information about the sphenoid sinus and surrounding structures that is essential for avoiding complications in performing an endoscopic sphenoidotomy.

Evaluation of swallowing pressure in a patient with amyotrophic lateral sclerosis before and after cricopharyngeal myotomy using high-resolution manometry system

BACKGROUND This study aimed to evaluate the pharyngeal pressure of a patient with, amyotrophic lateral sclerosis (ALS) before and after cricopharyngeal myotomy by high-resolution manometry (HRM) system. METHODS A 60-year-old man with ALS underwent cricopharyngeal myotomy for his intractable, aspiration. The swallowing pressure along the velopharynx and upper esophagus was measured using, the HRM 1 month before and 3 months after the surgery. RESULTS Before cricopharyngeal myotomy, the maximum values of the resting UES pressure, the dry swallowing, pressures in the velopharyngeal muscle zone and in the UES zone were 89, 95, and 171 mmHg, respectively. After surgery, the maximum values of both the resting pressure and dry swallowing, pressure in the UES zone remarkably decreased to 21 and 75 mmHg, respectively. CONCLUSIONS This is the first report showing the effect of cricopharyngeal myotomy by demonstrating, the difference in the swallowing pressure along the velopharynx and upper esophagus before and after, the surgery in an ALS patient using this HRM system.

Traumatic pseudolipoma of the buccal fat pad

Title Traumatic pseudolipoma of the buccal fat pad. Author(s) Takasaki, Kenji; Kihara, Chiharu; Enatsu, Kaori; Kumagami, Hidetaka; Takahashi, Haruo Citation Otolaryngology Head and Neck Surgery. 136(5), pp.858-859; 2005 Issue Date 2007-05 URL http://hdl.handle.net/10069/20151 Right Copyright

The Patulous Eustachian Tube Complicated With Amyotrophic Lateral Sclerosis: A Video Clip Demonstration

We report a 60‐year‐old case diagnosed as the amyotrophic lateral sclerosis with patulous eustachian tube (ET). To our knowledge, this is the first case report of the amyotrophic lateral sclerosis complicating patulous ET in the literature, demonstrating the movement of the tympanic membrane, the pharyngeal orifice of the ET and abnormal movement of the uvula because of paralysis of the soft palate on video.

Concentrations of h1-receptor antagonist in the human nasal mucosa.

Aims. To measure blood and tissue concentrations of the H1-receptor antagonist, bepotastine besilate (BB). Methods. Participants included 14 men and six women, whose age ranged from 13 to 76 years, with chronic rhinosinusitis, who underwent endoscopic sinus surgery at our university hospital. Among them, 10 participants had allergic rhinitis (AR) (Group I), and others did not have AR (Group II). Nasal mucosa and blood were collected 55 to 130 minutes after oral administration of BB 10 mg. Concentrations of the agent in the serum and nasal mucosa were measured by high-performance liquid chromatography. Results. Concentrations of BB of the serum in Group I and II were 98 ± 32 ng/mL and 112 ± 39 ng/mL. Those of the nasal mucosa tissue in Groups I and II were 101 ± 36 ng/g and 132 ± 44 ng/g. There was no significant difference in the values of concentration of BB between the serum and the nasal mucosa in either Group I or II (P = .757 and P = .2662, resp., Paired t-test). Conclusion. This preliminary study is considered the first report on the concentration of H1-receptor antagonists in nasal mucosa. The prompt absorption and transition to the nasal mucosa of BB seems to have an effect on allergic rhinitis.

Fifty-four wooden toothpicks in the nasal cavity.

A 26-year-old man, who was in prison, visited our linic complaining of left nasal discharge and severe eadache for the last 11 months. Nasal endoscopy evealed multiple toothpicks with massive bloody puulent granulation tissue in his left nasal cavity. Comuted tomography (CT) demonstrated low-density aras in his left nasal cavity and maxillary and ethmoid inuses without bone destruction (Fig 1). A total of 48 ooden toothpicks 2.25 mm in diameter and 65.5 mm n length were removed from his left nasal cavity at our linic. Furthermore, another 6 toothpicks came out hen he blew his nose at prison 10 days later. Now 16 onths have passed since the treatment, his nasal conition is normal endoscopically.

S119 – Tongue-holding Maneuver Studied by High-resolution Manometry

Objectives This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing, using a novel high-resolution manometry (HRM) system. Methods 27 asymptomatic adult Japanese controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the dry swallowing pressures at meso-hypopharynx, the upper esophageal sphincter (UES) and the mean values at meso-hypopharynx with and without THM were measured. Results The maximum values of dry swallowing pressures with and without THM were 195.0±77.2 (mmHg, mean ± standard deviation), and 178.1±53.0 at the meso-hypopharynx, and 213.4±74.0 and 190.0±95.0 at the UES, respectively. The mean values with and without THM at meso-hypopharynx were 47.4±11.9, and 44.0±11.2, respectively. The maximum value at UES (p=0.0347), and the mean value at the meso-hypopharynx (p=0.0124) of dry swallowing pressures with THM were significantly higher than those without THM. Conclusions These findings indicate that the THM has a potential to facilitate compensatory swallowing power at the pharynx and upper esophagus. HRM will provide us with important information about the swallowing physiology, and pathophysiology along the velopharynx, and upper esophagus.