Coordination of deglutitive vocal cord closure and oral-pharyngeal swallowing events in the elderly.
OBJECTIVE
The temporal relationship between deglutitive glottic closure, oropharyngeal bolus transit and other biomechanical swallowing events was studied in 10 healthy elderly subjects by concurrent transnasal videolaryngoscopy, videofluoroscopy, intraluminal pharyngeal manometry and submental electromyography. The results were compared with those of a similar study in a group of young healthy volunteers published previously.


RESULTS
Overall, the coordination of various deglutitive biomechanical events in the elderly group was found to be similar to that in the young. However, subtle differences were documented. Contrary to historical young controls, where the onset of the bolus movement from the mouth toward the pharynx invariably occurred after the vocal cords reached their maximum adduction, in the elderly this relationship was variable. In all swallows of two subjects it occurred 0.41 +/- 0.2 s after, and in another two it occurred 0.08 +/- 0.06 s before the maximal vocal cord adduction. Six subjects showed interchanging patterns. Except for the above-mentioned changes, the onset of vocal cord adduction in the elderly also preceded all other studied events, similar to previously published data in the young. In the elderly, the total duration between onset of vocal cord adduction and their complete reopening (2.47 +/- 0.1 s) was similar to that in the young.


CONCLUSIONS
Although subtle alterations occur in the coordination of deglutitive vocal cord closure and oropharyngeal bolus transit in some elderly people, the overall coordination between airway protection and the transit aspect of the oral-pharyngeal phase of swallowing is preserved in the elderly.
Zamir
Z
Z
Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.
Ren
J
J
Hogan
W J
WJ
Shaker
R
R
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001696:Biomechanical Phenomena; D003679:Deglutition / Q000502:physiology*; D006801:Humans; D010614:Pharynx / Q000502:physiology; D014827:Vocal Cords / Q000502:physiology*