Pharyngeal Constriction in Elderly Dysphagic Patients Compared with Young and Elderly Nondysphagic Controls

Abstract

This article reports the results of our study to determine the incidence of abnormalities in timing and extent of pharyngeal constriction in an elderly population with complaints of dysphagia. We performed a retrospective analysis of videofluoroscopic studies, i.e.. dynamic swallow studies, that were performed between 1996 and 1999. Included in the study were patients over 65 years old without an obvious medical or surgical cause for their dysphagia complaints. The timing of maximum pharyngeal constriction was measured relative to the onset of bolus pharyngeal transit, relative to the arrival of the bolus at the upper esophageal sphincter, and relative to the exit of the tail of the bolus from the upper esophageal sphincter. The extent of maximum pharyngeal constriction was measured from a lateral view. Patient data were compared with data gathered from young (18-62 years old) nondysphagic controls and with data gathered from elderly (67-83 years old) nondysphagic controls. We found that 73% of the patient population demonstrated incomplete pharyngeal constriction relative to controls, although the timing of pharyngeal constriction remained coordinated relative to the position of the bolus in the pharynx. Poor pharyngeal constriction, suggestive of pharyngeal weakness, contributed to 75% of the cases of aspiration.

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.…”

Aspiration and swallowing in Parkinson disease and rehabilitation with EMST

“…15 Decreased elevation and excursion of the hyolaryngeal complex is considered one cause of penetration and aspiration. [18][19][20][21] Submental muscle contraction elevates the hyolaryngeal complex. EMST treatment produces significantly longer durations, higher peak amplitudes, and greater average amplitudes of the submental muscles' EMG signal when compared to dry and wet swallows.…”

Aging Decreases the Strength of Suprahyoid Muscles Involved in Swallowing Movements

“…For example, pharyngeal swallowing strength can be measured indirectly by videofluorographic measurement of pharyngeal contraction (Kendall and Leonard 2001) with a tongue pressure-measuring device (Ono et al 2004) or with pharyngeal pressure sensor (manometry) (Nativ-Zeltzer et al 2012). These methods require specialized equipment and technical expertise.…”