The mechanism and clinical application of head rotation swallowing in dysphagia rehabilitation Tatsuyuki Fukuoka 1 Keyword: 嚥下障害 , 頸部回旋 , 梨状窩 , リハビリテーション , dysphagia , head rotation , pyriform sinus , rehabilitation pp.34-39
Published Date 2019/3/15
DOI https://doi.org/10.11477/mf.6001200213
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 Head rotation is one of the postural modulations available for patients with dysphagia. Changes in the shape of the pharynx and pressure changes in the upper esophagus sphincter have been the immediate effects reported in head rotation swallowing. Head rotation can be applied for patients with post-swallow residue in the pharynx and laterality of pharyngeal bolus passage such as in bulbar palsy or in unilateral laryngeal and pharyngeal paralysis. The criteria for adjusting the angle of head rotation are unclear. Past studies showed that the bolus passes through the side opposite to the rotating side with 30 degrees of head rotation, and this serves as a useful reference. Swallowing with head rotation after normal swallowing is used to clear the pyriform sinus. Although this strategy usually involves rotation to the contralateral side of the side with residual food, some patients may benefit from rotation to the side with residual food for clearance. The risk of aspiration may increase by simply combining a reclining position and head rotation, so it is important to consider adding trunk rotation to control the bolus during unilateral swallowing.

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