{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T22:26:12Z","timestamp":1749853572827,"version":"3.37.3"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T00:00:00Z","timestamp":1495497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P01DK068051","R01DK025731","T32DK061923"],"award-info":[{"award-number":["P01DK068051","R01DK025731","T32DK061923"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>External cricoid pressure is increasingly used to augment the upper esophageal sphincter (UES). Our objective was to determine the effect of 1) pressures applied to cricoid, supracricoid, and subcricoid regions on the length and amplitude of the UES high\u2010pressure zone (UESHPZ), and 2) the external cricoid pressure on lower esophageal sphincter (LES) tone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case\u2010control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied 11 patients with supraesophageal reflux (mean age 58\u2009\u00b1\u200912 years) and 10 healthy volunteers (mean age 47\u2009\u00b1\u200919 years). We tested 20, 30, and 40\u2009mm Hg pressures to cricoid, 1\u2009cm proximal and 1\u2009cm distal to the cricoid. In an additional 15 healthy volunteers (mean age 46\u2009\u00b1\u200923 years), we studied the effect of external cricoid pressure on LES tone. UES and LES pressures were determined using high\u2010resolution manometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was significant increase of UESHPZ length with application of pressure at all sites. The increase of UESHPZ length was relatively symmetric, more orad, and more caudad when the pressure was applied at the cricoid, supracricoid, and subcricoid levels, respectively. The magnitude of pressure increase was greatest at the middle and orad part of the UESHPZ when the pressure was applied at the cricoid and supracricoid levels, respectively. The corresponding magnitude of increase in the caudad part of the UESHPZ was not observed with pressure at the subcricoid level. There was no change of the LES pressure with application of cricoid pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The effect of external pressure on the UESHPZ is site dependent. Subcricoid pressure has the least effect on UESHPZ. External cricoid pressure at 20 to 40\u2009mm Hg has no effect on the LES pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3b. <jats:italic>Laryngoscope<\/jats:italic>, 127:2466\u20132474, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26642","type":"journal-article","created":{"date-parts":[[2017,5,24]],"date-time":"2017-05-24T00:48:56Z","timestamp":1495586936000},"page":"2466-2474","source":"Crossref","is-referenced-by-count":2,"title":["Comparative effect of the sites of anterior cervical pressure on the geometry of the upper esophageal sphincter high\u2010pressure zone"],"prefix":"10.1002","volume":"127","author":[{"given":"Ling","family":"Mei","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Medical College of Wisconsin Milwaukee Wisconsin U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongmei","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of 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