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Normal Variations in Upper Esophageal Sphincter Function During Deglutition: A Secondary Analysis of Videofluoroscopic Data.
Ambrocio, Kevin Renz; Ramsey, Reagan; O'Rourke, Ashli; Beall, Jonathan; Garand, Kendrea L.
Affiliation
  • Ambrocio KR; Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Ramsey R; Department of Speech Pathology & Audiology, University of South Alabama, Mobile, Alabama, USA.
  • O'Rourke A; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Beall J; Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Garand KL; Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Laryngoscope ; 134(5): 2306-2315, 2024 May.
Article in En | MEDLINE | ID: mdl-37962100
ABSTRACT

OBJECTIVE:

Cricopharyngeal dysfunction is a common potential cause of pharyngoesophageal dysphagia. Contextual factors (i.e., personal demographics and bolus properties) appear to impact upper esophageal sphincter (UES) function but have yet to be assessed collectively in a large-scale study using psychometrically sound swallow task procedures. Using a standardized and validated videofluoroscopic approach, we investigated the collective effects of age, sex, and swallow task on UES opening duration (UESOdur) and UES maximum distension (UESmax) in a large sample of healthy adults.

METHODS:

UESOdur and UESmax data were analyzed from existing videofluoroscopic images of 195 healthy adults (21-89 years old) across seven swallow tasks (thin liquid to viscous liquids, puree, and a solid). Generalized estimating equation modeling captured the effects of the aforementioned contextual factors (α = 0.05).

RESULTS:

UESOdur significantly increased with age, while UESmax had an inverse relationship. Females had significantly wider UESmax. UESOdur of 5 mL thin liquid was significantly shorter than all other liquid swallow tasks, while solid had an inverse effect. Compared to 5 mL thin liquid, all other swallow tasks resulted in significantly wider UESmax. Mildly and moderately thick liquid significantly increased UESOdur when isolating viscosity. UESmax was significantly wider with mildly and moderately thick liquid and puree than thin liquid. When isolating volume, cup sip thin liquid increased both measures significantly relative to 5 mL.

CONCLUSION:

Age, sex, and swallow task can influence the normal timing and extent of UES movement. These collective effects contribute to normal variability in UES function and should be considered for clinical decision-making. LEVEL OF EVIDENCE 4 Laryngoscope, 1342306-2315, 2024.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Deglutition Disorders / Laryngoscopes Limits: Adult / Aged / Aged80 / Female / Humans / Middle aged Language: En Journal: Laryngoscope Journal subject: OTORRINOLARINGOLOGIA Year: 2024 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Deglutition Disorders / Laryngoscopes Limits: Adult / Aged / Aged80 / Female / Humans / Middle aged Language: En Journal: Laryngoscope Journal subject: OTORRINOLARINGOLOGIA Year: 2024 Document type: Article Affiliation country: