Comparison of upper esophageal sphincter opening in healthy asymptomatic young and elderly volunteers

Deglutitive upper esophageal sphincter opening (UES) in the elderly has bee n incompletely studied. Our aim was to determine in the elderly the tempora l and dimensional characteristics of deglutitive UES opening; anterior and superior hyoid and laryngeal excursions as measures of distracting forces i mparted 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 1 0-mL barium boluses. The anteroposterior UES diameter, as well as the anter ior hyoid bone and laryngeal excursion. was significantly smaller in the el derly compared to the young (p <.05) for 5-mL barium boluses, but not for 1 0-mL boluses. The lateral diameter of UES opening was similar between group s for all boluses. The IBP for 5- and 10-mL swallows in the elderly was sig nificantly higher than that in the young (p <.05). We conclude that anterop osterior deglutitive UES opening and hyoid bone and thyroid cartilage anter ior excursion are reduced in the elderly. These changes are associated with increased IBP, suggesting a higher pharyngeal outflow resistance in the el derly compared to the young.