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Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis

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Abstract

Age-related loss of muscle bulk and strength (sarcopenia) is often cited as a potential mechanism underlying age-related changes in swallowing. Our goal was to explore this phenomenon in the pharynx, specifically, by measuring pharyngeal wall thickness and pharyngeal lumen area in a sample of young versus older women. MRI scans of the neck were retrospectively reviewed from 60 women equally stratified into three age groups (20s, 60s, 70+). Four de-identified slices were extracted per scan for randomized, blinded analysis: one mid-sagittal and three axial slices were selected at the anterior inferior border of C2 and C3, and at the pit of the vallecula. Pixel-based measures of pharyngeal wall thickness and pharyngeal lumen area were completed using ImageJ and then converted to metric units. Measures of pharyngeal wall thickness and pharyngeal lumen area were compared between age groups with one-way ANOVAs using Sidak adjustments for post-hoc pairwise comparisons. A significant main effect for age was observed across all variables whereby pharyngeal wall thickness decreased and pharyngeal lumen area increased with advancing age. Pairwise comparisons revealed significant differences between 20s versus 70+ for all variables and 20s versus 60s for all variables except those measured at C2. Effect sizes ranged from 0.54 to 1.34. Consistent with existing sacropenia literature, the pharyngeal muscles appear to atrophy with age and consequently, the size of the pharyngeal lumen increases.

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References

  1. Kahrilas PJ, Logemann JA, Lin S, Ergun GA. Pharyngeal clearance during swallowing: a combined manometric and videofluoroscopic study. Gastroenterology. 1992;103(1):128–36.

    CAS  PubMed  Google Scholar 

  2. Leonard R, Kendall KA, McKenzie S. Structural displacements affecting pharyngeal constriction in nondysphagic elderly and nonelderly adults. Dysphagia. 2004;19(2):133–41.

    Article  PubMed  Google Scholar 

  3. Logemann JA. Evaluation and treatment of swallowing disorders. 2nd ed. Austin, TX: Pro-Ed; 1998.

    Google Scholar 

  4. Leonard R, Rees CJ, Belafsky P, Allen J. Fluoroscopic surrogate for pharyngeal strength: the pharyngeal constriction ratio (PCR). Dysphagia. 2011;26(1):13–7.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Palmer JB, Tanaka E, Ensrud E. Motions of the posterior pharyngeal wall in human swallowing: a quantitative videofluorographic study. Arch Phys Med Rehabil. 2000;81(11):1520–6.

    Article  CAS  PubMed  Google Scholar 

  6. Olsson R, Castell J, Johnston B, Ekberg O, Castell DO. Combined videomanometric identification of abnormalities related to pharyngeal retention. Acad Radiol. 1997;4(5):349–54.

    Article  CAS  PubMed  Google Scholar 

  7. Pauloski BR, Logemann JA, Fox JC, Colangelo LA. Biomechanical analysis of the pharyngeal swallow in postsurgical patients with anterior tongue and floor of mouth resection and distal flap reconstruction. J Speech Hear Res. 1995;38(1):110–23.

    Article  CAS  PubMed  Google Scholar 

  8. Ekberg O, Nylander G. Pharyngeal constrictor paresis in patients with dysphagia: a cineradiographic study. Clin Radiol. 1982;33(3):253–8.

    Article  CAS  PubMed  Google Scholar 

  9. Dejaeger E, Pelemans W, Ponette E, Joosten E. Mechanisms involved in postdeglutition retention in the elderly. Dysphagia. 1997;12(2):63–7.

    Article  CAS  PubMed  Google Scholar 

  10. Perlman AL, Booth BM, Grayhack JP. Videofluoroscopic predictors of aspiration in patients with oropharyngeal dysphagia. Dysphagia. 1994;9(2):90–5.

    Article  CAS  PubMed  Google Scholar 

  11. Berger MJ, Doherty TJ. Sarcopenia: prevalence, mechanisms, and functional consequences. Interdiscip Topics Gerontol. 2010;37:94–114.

    Google Scholar 

  12. Robbins J, Kays SA, Gangnon RE, Hind JA, Hewitt AL, Gentry LR, et al. The effects of lingual exercise in stroke patients with dysphagia. Arch Phys Med Rehabil. 2007;88(2):150–8.

    Article  PubMed  Google Scholar 

  13. Robbins J, Gangnon RE, Theis SM, Kays SA, Hewitt AL, Hind JA. The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc. 2005;53(9):1483–9.

    Article  PubMed  Google Scholar 

  14. Ota F, Connor NP, Konopacki R. Alterations in contractile properties of tongue muscles in old rats. Ann Otol Rhinol Laryngol. 2005;114(10):799–803.

    Article  PubMed  Google Scholar 

  15. Nagai H, Russell JA, Jackson MA, Connor NP. Effect of aging on tongue protrusion forces in rats. Dysphagia. 2008;23(2):116–21.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Feng X, Todd T, Lintzenich CR, Ding J, Carr JJ, Ge Y, et al. Aging-related geniohyoid muscle atrophy is related to aspiration status in healthy older adults. J Gerontol Ser A Biol Sci Med Sci. 2013;68(7):853–60.

    Article  Google Scholar 

  17. Kendall KA, Leonard RJ. Pharyngeal constriction in elderly dysphagic patients compared with young and elderly nondysphagic controls. Dysphagia. 2001;16(4):272–8.

    Article  CAS  PubMed  Google Scholar 

  18. Aminpour S, Leonard R, Fuller SC, Belafsky PC. Pharyngeal wall differences between normal younger and older adults. ENT: Ear Nose Throat J 2011;90(4):E1–E5.

    PubMed  Google Scholar 

  19. Molfenter SM, Steele CM. Use of an anatomical scalar to control for sex-based size differences in measures of hyoid excursion during swallowing. J Speech Lang Hearing Res 2014;57(3):768–778.

    Article  Google Scholar 

  20. Chitose S, Haraguchi M, Nagata S, Katayama R, Sato K, Fukahori M, et al. Analysis of passive motion of para-and retropharyngeal structures during swallowing using dynamic magnetic resonance imaging. Dysphagia 2014;29(3):387–395.

    Article  PubMed  Google Scholar 

  21. Fleiss JL. The design and analysis of clinical experiments. New York: Wiley; 1986.

    Google Scholar 

  22. Kotrlik J, Williams H. The incorporation of effect size in information technology, learning, and performance research. Inform Technol Learn Perform. 2003;21:1.

    Google Scholar 

  23. Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y, et al. Aspects of swallowing in healthy dentate elderly persons older than 80 years. J Gerontol A Biol Sci Med Sci. 2005;60(4):506–9.

    Article  PubMed  Google Scholar 

  24. Cook I, Weltman M, Wallace K, Shaw D, McKay E, Smart R, et al. Influence of aging on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study. American Journal of Physiology-Gastrointestinal and Liver. Physiology. 1994;29(6):G972.

    Google Scholar 

  25. Ekberg O, Feinberg MJ. Altered swallowing function in elderly patients without dysphagia: radiologic findings in 56 cases. Am J Roentgenol. 1991;156(6):1181–4.

    Article  CAS  Google Scholar 

  26. Dejaeger E, Pelemans W, Bibau G, Ponette E. Manofluorographic analysis of swallowing in the elderly. Dysphagia. 1994;9(3):156–61.

    Article  CAS  PubMed  Google Scholar 

  27. Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M. Menopause and sarcopenia: a potential role for sex hormones. Maturitas. 2011;68(4):331–6.

    Article  CAS  PubMed  Google Scholar 

  28. Xue SA, Hao GJ. Changes in the human vocal tract due to aging and the acoustic correlates of speech production: a pilot study. J Speech Lang Hearing Res. 2003;46:689–701.

    Article  Google Scholar 

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Acknowledgments

The authors would like to acknowledge Dr. Stratos Achlatis for assistance in study planning and Jane Kelly for assistance with reliability analysis. Age-related changes in pharyngeal lumen size: A retrospective MRI analysis.

Conflicts of interest

This work has been accepted for oral presentation at the 2015 Dysphagia Research Society Meeting. No conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Communicative Sciences & Disorders, Steinhardt, New York University, 665 Broadway, Room 934, New York, NY, 10012, USA

    Sonja M. Molfenter

  2. Otolaryngology-Head and Neck Surgery, New York University Langone Medical Center, New York, NY, USA

    M. R. Amin, R. C. Branski, J. D. Brumm & S. A. Roof

  3. Department of Radiology, New York University Langone Medical Center, New York, NY, USA

    M. Hagiwara

  4. Otolaryngology-Head & Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA

    C. L. Lazarus

Authors
  1. Sonja M. Molfenter
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  2. M. R. Amin
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  3. R. C. Branski
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  4. J. D. Brumm
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  5. M. Hagiwara
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  7. C. L. Lazarus
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Correspondence to Sonja M. Molfenter.

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Molfenter, S.M., Amin, M.R., Branski, R.C. et al. Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis. Dysphagia 30, 321–327 (2015). https://doi.org/10.1007/s00455-015-9602-9

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  • DOI: https://doi.org/10.1007/s00455-015-9602-9

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