Normal Variation in Pharyngeal Swallow Times in Elderly

Dr. Robbins' work has shown that the duration of stage transition is longer in the elderly. Translated, the bolus head (with liquids) is past the ramus of the mandible for a second or two in some cases, in healthy elderly subjects (Robbins, Hamilton, Lof, & Kempster, 1992). As you know the "top" of the valleculae lie at the plane of the mandibular ramus.

That would be Hiiemae and Palmer (1999), and Saitoh, et al., 2006. These investigators found that with solids and soft solids as well as chewed foods, the bolus head tended to lie anywhere from the valleculae to the pyriform sinuses for up to many seconds, even in non-old subjects. For this reason the measure traditionally used to indicate "pharyngeal delay" (i.e. the duration of stage transition) is no longer valid for solids (Hiiemae & Palmer, 1999; Saitoh et al., 2007).


James L. Coyle

University of Pittsburgh
References

Hiiemae, K. M. & Palmer, J. B. (1999). Food transport and bolus formation during complete feeding sequences on foods of different initial consistency. Dysphagia, 14, 31-42.
Robbins, J., Hamilton, J. W., Lof, G. L., & Kempster, G. B. (1992). Oropharyngeal swallowing in normal adults of different ages. Gastroenterology, 103, 823-829.
Saitoh, E., Shibata, S., Matsuo, K., Baba, M., Fujii, W., & Palmer, J. B. (2007). Chewing and food consistency: effects on bolus transport and swallow initiation. Dysphagia, 22, 100-107.