Age-related changes of hyoid bone position in healthy older adults with aspiration.
OBJECTIVE
Aspiration, the passage of a bolus below the vocal folds, increases morbidity and mortality in the elderly by increasing the risk of aspiration pneumonia and other conditions. We hypothesized that altered position of the hyoid bone associated with aging may negatively affect airway protection during swallowing (i.e., aspiration) in older adults.


METHODS
Retrospective study.


METHODS
We re-reviewed computed tomography (CT) scans of the head from 40 older adults (65-80 years old), comprised of 20 aspirators and 20 nonaspirators, obtained from a previous cohort study. In addition, CT scans of the head from 40 young adults (20-40 years old) were retrieved from a medical records database. Three-dimensional reconstruction and 2-dimensional sagittal views were used to measure the distance between the mandible and hyoid bone. Comparisons between age groups, genders, and aspiration status were made.


RESULTS
Older adults had a larger distance between the hyoid and mandible in both latitude and longitudinal positions compared to the young adults. Among older males, there was evidence that the hyoid bone in the aspirators tended to be positioned more posterior compared to the nonaspirators.


CONCLUSIONS
The distance between the hyoid and mandible is increased with aging, and a more posterior position of the hyoid bone is correlated with aspiration in older males. These findings suggest that age-related changes in hyoid bone position may be a component of decreased swallowing safety and aspiration in older adults and warrant further investigation.


METHODS
N/A.
Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A.
Xin
X
Feng
Tee
T
Todd
Yunping
Y
Hu
Catherine R
CR
Lintzenich
J Jeffrey
JJ
Carr
James D
JD
Browne
Stephen B
SB
Kritchevsky
Susan G
SG
Butler
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008297:Male; D008334:Mandible / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D015999:Multivariate Analysis; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
Mandible; aging; aspiration; computed tomography; hyoid; swallowing