The Benefit of Head Rotation on Pharyngoesophageal Dysphagia. From Three Cases of Paraganglioma in the Parapharyngeal Space.

Rehabilitation of Dysphagia Following Head and Neck Cancer

“…Head rotation to the weaker side causes the bolus to lateralize away from the direction of rotation, and also increases upper esophageal sphincter (UES) opening diameter while causing a significant reduction in UES pressure [164]. During head rotation, compensatory movement of the arytenoid on the healthy side has been observed on videofluoroscopy [165]. Serial computed tomography of the pharynx in a patient with lateral medullary syndrome using head rotation indicates that hemipharyngeal closing occurs at the level of the hyoid bone and in the hypopharyngeal cavity above the pyriform sinus [166].…”

“…Since head rotation may cause compensatory movement of the arytenoid on the healthy side [165], this posture may be effective in hemilarygectomee patients who have difficulty achieving closure of the remaining vocal fold against the reconstructed pseudocord. Also, since UES opening diameter is increased and resting pressure is decreased during head rotation, patients with cricopharyngeal dysmotility problems may also benefit from the posture.…”

Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery

“…The chin down posture carried out either alone or along with other postures or maneuvers, has been reported to yield successful results in postsurgical patients with head and neck cancer; specifically, aspiration was decreased or eliminated in 50% of patients with tongue base resection and 90% of patients with oral or laryngeal resection [ 321 , 324 ]. The head rotation posture induces compensatory movements in the healthy side of the arytenoid, which might effectively reduce aspiration in posthemilaryngectomy patients experiencing difficulties in closure of remaining vocal fold [ 325 ].…”