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Deterioration of the Pharyngo‐UES Contractile Reflex in the Elderly
Author(s) -
Ren Junlong,
Xie Pengyan,
Lang Ivan M.,
Bardan Eytan,
Sui Zhumei,
Shaker Reza
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200009000-00031
Subject(s) - reflex , medicine , pharynx , anesthesia , stimulation , vagovagal reflex , cardiology , surgery
Objectives/Hypothesis Deterioration of aerodigestive tract reflexes such as the esophagoglottal and pharyngoglottal closure reflexes and pharyngeal swallow has been documented in the elderly. However, the effect of aging on the contractile response of the upper esophageal sphincter (UES) to pharyngeal water stimulation has not been studied. The aim of this study was to characterize the pharyngo‐UES reflex in the healthy elderly. Methods We studied nine healthy elderly (77 ± 1 y [SD]; four men, five women) and nine healthy young volunteers (26 ± 2 y [SD]; four men, five women). A UES sleeve sensor was used to measure the pressure. We tested pharyngeal stimulation induced by rapid pulse and slow continuous injection of water. Results The volume of water required to stimulate the pharyngo‐UES contractile reflex by rapid pulse injection in the elderly (0.5 ± 34 0.1 mL) was significantly higher than that in the young (0.1 ± 0.02 mL) ( P < .05). In contrast to young subjects, there was no pressure increase in resting UES pressure observed in the elderly for continuous pharyngeal water infusion. In both young and elderly, the threshold volume for the pharyngo‐UES contractile reflex was significantly lower than that for pharyngeal swallows. Conclusions The pharyngo‐UES contractile reflex deteriorates with aging. This deterioration is primarily due to abnormalities of the afferent limb of the reflex.