Structural Displacements Affecting Pharyngeal Constriction in Nondysphagic Elderly and Nonelderly Adults

Abstract

This study investigated spatial displacement variables important to pharyngeal constriction and clearing in nondysphagic elderly subjects and a control group of nondysphagic younger adults. Height, weight, and body mass index (BMI) characteristics were determined for all subjects, who then underwent videofluoroscopic swallow studies. Measures obtained during swallow of a 20-cc bolus included hyoid and laryngeal displacement, unobliterated pharyngeal space at the point of maximum pharyngeal constriction, and pharyngeal width when maximally expanded during the swallow. Data were first examined to determine if elderly subjects with medical conditions common to an aged population differed from elderly subjects with no medical condition. No differences were identified and data for all elderly subjects were subsequently pooled for comparison to data for the nonelderly control group. Findings revealed no differences in maximum hyoid displacement between the groups. Significant differences were identified for larynx-to-hyoid approximation and for the measure representing unobliterated pharyngeal space at the point of maximum pharyngeal constriction. Elderly subjects did not elevate the larynx to the same extent, or clear the pharynx, as well as the younger control subjects. In addition, data suggested that the larynx was positioned lower and that the width of the pharynx maximally expanded was greater in elderly subjects. Implications of the data for swallowing function in the elderly are discussed.

Análise quantitativa da deglutição de parkinsonianos pré e pós-riboflavina

“…Compared to the data in the literature 14,[23][24][25][26][27][28][29] the measurement values of the hyoid bone displacement, maximum pharyngeal constriction and maximum UES opening were found to be higher, even when compared to nondysphagic individuals. Such a fact may result from different methods to take measurements, thus preventing a comparison of these data.…”

“…Quando comparados com dados da literatura 14,[23][24][25][26][27][28][29] os valores das medidas de máximo deslocamento do osso hióide, máxima constrição da faringe, e máxima abertura da TFE encontraram-se maiores, mesmo na comparação com indivíduos não disfágicos. Tal fato pode ser decorrente de metodologias diferentes na realização das promoting lower strength, and consequent less displacement, by the individual.…”

Structural Displacements During the Swallow in Patients with Early Laryngeal Cancers and Other Early Primary Cancers of the Head and Neck

“…We found no differences in spatial movements between this cohort and a separate heterogeneous cohort of 24 patients with cancers of the head and neck in a variety of locations that would not be expected to interfere with the pharyngeal swallowing process. In addition, many of the spatial measurements that we have recorded are similar to those previously recorded in volunteers with normal swallows [14,[17][18][19][20][21]. It is thus reasonable to assume that we proved the hypothesis that patients with T1 laryngeal cancer have normal swallows.…”

“…An adaptation of Leonard and Kendall's methodology was employed for the evaluation of swallow function using videofluoroscopy [12][13][14]. Interobserver reliability among three judges (SF, SG, and SV) was established on analysis of the swallow sets of the first 20 patients included in the study.…”

“…1c) (8) Maximum pharyngo-oesophageal sphincter opening size (PESlatmax) was also measured at the location of the distal manometry sensor, which had been initially placed across the PES (9) Hyoid-larynx distance at the point of maximum approximation (HyLamax) (Fig. 1f) (10) Epiglottis downfolding during the swallow was rated as complete, incomplete, or absent [14] The following measurement was made from the AP view: the maximal AP pharyngo-oesophageal sphincter opening size (PESapmax, Fig. 1d).…”