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Histological observations of age-related changes in the epiglottis associated with decreased deglutition function in older adults

  • Masamitsu Serikawa (Department of Morphological Biology, Ohu University School of Dentistry) ;
  • Kimiharu Ambe (Department of Morphological Biology, Ohu University School of Dentistry) ;
  • Akinobu Usami (Department of Morphological Biology, Ohu University School of Dentistry)
  • Received : 2023.03.22
  • Accepted : 2023.04.14
  • Published : 2023.09.30

Abstract

Although the epiglottis plays a vital role in deglutition, histological studies of the epiglottis and surrounding ligaments associated with swallowing dysfunction are limited. Therefore, we performed histological observations to clarify age-related changes in the morphological characteristics of the epiglottis and surrounding structures. Tissue samples comprising the epiglottis and surrounding structures were collected from corpses that were both orally fed and tubefed during their lifetimes. Following hematoxylin and eosin, Elastica Van Gieson, and immunohistochemical staining procedures, the chondrocytes, connective tissue, and glandular tissue were observed under the epiglottis epithelium, and intervening adipose tissue was observed in the surrounding area. Fatty degeneration of acinar cells was also observed in the glandular tissue, possibly because of aging. Bundles of elastic fibers were present around the vascular wall in the peri-epiglottic ligament, but some were reduced. Furthermore, large amounts of collagen fibers ran toward and through the cartilage, whereas the mesh-like elastic fibers stopped in front of the cartilage. Microfibrils considered to be oxytalan fibers, which are thinner and shorter than elastic fibers, were observed around the vascular wall and in the fiber bundles. Age-related changes included connective tissue fibrosis shown by the large amount of collagen fibers, atrophy of salivary glands, and an accompanying increase in adipose tissue. Regarding stretchability and elasticity, the elastic fibers may have an auxiliary function for laryngeal elevation during deglutition. This suggests that disuse atrophy of the laryngeal organs with or without oral intake might reduce the amount of elastic fiber in older adults.

Keywords

References

  1. Lamb J. Movements and functions of the epiglottis during deglutition. Edinb Dent Hosp Gaz 1974;13:22-30. 
  2. Gleeson DC. Oropharyngeal swallowing and aging: a review. J Commun Disord 1999;32:373-95; quiz 395-6. 
  3. Daniels SK, Corey DM, Hadskey LD, Legendre C, Priestly DH, Rosenbek JC, Foundas AL. Mechanism of sequential swallowing during straw drinking in healthy young and older adults. J Speech Lang Hear Res 2004;47:33-45. 
  4. Leonard R, Kendall KA, McKenzie S. Structural displacements affecting pharyngeal constriction in nondysphagic elderly and nonelderly adults. Dysphagia 2004;19:133-41. 
  5. Kang BS, Oh BM, Kim IS, Chung SG, Kim SJ, Han TR. Influence of aging on movement of the hyoid bone and epiglottis during normal swallowing: a motion analysis. Gerontology 2010;56:474-82. 
  6. Satoda T, Shimoe S, Makihira S, Tamamoto M, Murayama T, Nikawa H. [Model for the functional instruction of swallowing]. Kaibogaku Zasshi 2008;83:51-7. Japanese. 
  7. Standring S. Gray's anatomy: the anatomical basis of clinical practice. 41st ed. Elsevier; 2016. p. 583. 
  8. Tamine K, Ono T, Hori K, Kondoh J, Hamanaka S, Maeda Y. Age-related changes in tongue pressure during swallowing. J Dent Res 2010;89:1097-101. 
  9. Inamoto Y, Saitoh E, Okada S, Kagaya H, Shibata S, Baba M, Onogi K, Hashimoto S, Katada K, Wattanapan P, Palmer JB. Anatomy of the larynx and pharynx: effects of age, gender and height revealed by multidetector computed tomography. J Oral Rehabil 2015;42:670-7. 
  10. Ximenes Filho JA, Tsuji DH, do Nascimento PH, Sennes LU. Histologic changes in human vocal folds correlated with aging: a histomorphometric study. Ann Otol Rhinol Laryngol 2003;112:894-8. 
  11. Kuhn MA. Histological changes in vocal fold growth and aging. Curr Opin Otolaryngol Head Neck Surg 2014;22:460-5. 
  12. Pellnitz D. [On change in the morphology of the human epiglottis due to aging]. Arch Ohren Nasen Kehlkopfheilkd 1961;178:350-4. German. 
  13. Kano M, Shimizu Y, Okayama K, Igari T, Kikuchi M. A morphometric study of age-related changes in adult human epiglottis using quantitative digital analysis of cartilage calcification. Cells Tissues Organs 2005;180:126-37. 
  14. JafariNasabian P, Inglis JE, Reilly W, Kelly OJ, Ilich JZ. Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. J Endocrinol 2017;234:R37-51. 
  15. Bender AD. The effect of increasing age on the distribution of peripheral blood flow in man. J Am Geriatr Soc 1965;13:192-8. 
  16. Henninger HB, Ellis BJ, Scott SA, Weiss JA. Contributions of elastic fibers, collagen, and extracellular matrix to the multiaxial mechanics of ligament. J Mech Behav Biomed Mater 2019;99:118-26. 
  17. Gumpangseth T, Lekawanvijit S, Mahakkanukrauh P. Histological assessment of the human heart valves and its relationship with age. Anat Cell Biol 2020;53:261-71. 
  18. Yabe Y, Hagiwara Y, Tsuchiya M, Honda M, Hatori K, Sonofuchi K, et al. Decreased elastic fibers and increased proteoglycans in the ligamentum flavum of patients with lumbar spinal canal stenosis. J Orthop Res 2016;34:1241-7. 
  19. Irvine LE, Yang Z, Kezirian EJ, Nimni ME, Han B. Hyoepiglottic ligament collagen and elastin fiber composition and changes associated with aging. Laryngoscope 2018;128:1245-8. 
  20. Sawatsubashi M, Umezaki T, Kusano K, Tokunaga O, Oda M, Komune S. Age-related changes in the hyoepiglottic ligament: functional implications based on histopathologic study. Am J Otolaryngol 2010;31:448-52. 
  21. Bock P. Elastic fiber microfibrils: filaments that anchor the epithelium of the epiglottis. Arch Histol Jpn 1983;46:307-14. 
  22. Goldfischer S, Coltoff-Schiller B, Schwartz E, Blumenfeld OO. Ultrastructure and staining properties of aortic microfibrils (oxytalan). J Histochem Cytochem 1983;31:382-90. 
  23. Strydom H, Maltha JC, Kuijpers-Jagtman AM, Von den Hoff JW. The oxytalan fibre network in the periodontium and its possible mechanical function. Arch Oral Biol 2012;57:1003-11. 
  24. Inoue K, Hara Y, Sato T. Development of the oxytalan fiber system in the rat molar periodontal ligament evaluated by light- and electron-microscopic analyses. Ann Anat 2012;194:482-8. 
  25. Giusti B, Pepe G. Fibrillins in tendon. Front Aging Neurosci 2016;8:237. 
  26. Barros EM, Rodrigues CJ, Rodrigues NR, Oliveira RP, Barros TE, Rodrigues AJ Jr. Aging of the elastic and collagen fibers in the human cervical interspinous ligaments. Spine J 2002;2:57-62. 
  27. Rodrigues CJ, Rodrigues Junior AJ. A comparative study of aging of the elastic fiber system of the diaphragm and the rectus abdominis muscles in rats. Braz J Med Biol Res 2000;33:1449-54. 
  28. Quintas ML, Rodrigues CJ, Yoo JH, Rodrigues Junior AJ. Age related changes in the elastic fiber system of the interfoveolar ligament. Rev Hosp Clin Fac Med Sao Paulo 2000;55:83-6. 
  29. Ramirez F, Pereira L. The fibrillins. Int J Biochem Cell Biol 1999;31:255-9 
  30. Finocchiaro E, Galletti R, Costantino A, Rivetti M, Xompero G, Aimonino N, Balzola F. [Enteral nutrition in the elderly]. Minerva Gastroenterol Dietol 1992;38:109-13. Italian. 
  31. Nogami T, Kurachi M, Hukushi T, Iwasaki K. Recovery of oral feeding in Japanese elderly people after long-term tube feeding: a challenge in Miyama Hospital. J Family Med Prim Care 2020;9:3977-80. 
  32. Katsume H, Furukawa K, Azuma A, Nakamura T, Matsubara K, Ohnishi K, Sugihara H, Asayama J, Nakagawa M. Disuse atrophy of the left ventricle in chronically bedridden elderly people. Jpn Circ J 1992;56:201-6. 
  33. Wall BT, Dirks ML, van Loon LJ. Skeletal muscle atrophy during short-term disuse: implications for age-related sarcopenia. Ageing Res Rev 2013;12:898-906.