title: Comparison of upper esophageal sphincter opening in healthy asymptomatic young and elderly volunteers.
abstract: Deglutitive upper esophageal sphincter opening (UES) in the elderly has been incompletely studied. Our aim was to determine in the elderly the temporal and dimensional characteristics of deglutitive UES opening; anterior and superior hyoid and laryngeal excursions as measures of distracting forces imparted on the UES; and hypopharyngeal intrabolus pressure (IBP). Fourteen healthy elderly and 14 healthy young volunteers were studied by concurrent videofluoroscopy and hypopharyngeal manometry during swallowing of 5- and 10-mL barium boluses. The anteroposterior UES diameter, as well as the anterior hyoid bone and laryngeal excursion, was significantly smaller in the elderly compared to the young (p < .05) for 5-mL barium boluses, but not for 10-mL boluses. The lateral diameter of UES opening was similar between groups for all boluses. The IBP for 5- and 10-mL swallows in the elderly was significantly higher than that in the young (p < .05). We conclude that anteroposterior deglutitive UES opening and hyoid bone and thyroid cartilage anterior excursion are reduced in the elderly. These changes are associated with increased IBP, suggesting a higher pharyngeal outflow resistance in the elderly compared to the young.
authors.affiliation: Medical College of Wisconsin Dysphagia Institute, Department of Medicine, Milwaukee, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kern
authors.forename: E
authors.initials: E
authors.lastname: Bardan
authors.forename: R
authors.initials: R
authors.lastname: Arndorfer
authors.forename: C
authors.initials: C
authors.lastname: Hofmann
authors.forename: J
authors.initials: J
authors.lastname: Ren
authors.forename: R
authors.initials: R
authors.lastname: Shaker
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D003679:Deglutition / Q000502:physiology*; D001330:Electronic Data Processing; D004943:Esophagogastric Junction / Q000502:physiology*; D005260:Female; D006801:Humans; D007013:Hypopharynx / Q000502:physiology; D008297:Male; D008365:Manometry; D013957:Thyroid Cartilage / Q000502:physiology; D013997:Time Factors