ORIGINAL ARTICLE Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis Sonja M. Molfenter • M. R. Amin • R. C. Branski • J. D. Brumm • M. Hagiwara • S. A. Roof • C. L. Lazarus Received: 21 October 2014 / Accepted: 16 February 2015 Ó Springer Science+Business Media New York 2015 Abstract Age-related loss of muscle bulk and strength (sarcopenia) is often cited as a potential mechanism un- derlying age-related changes in swallowing. Our goal was to explore this phenomenon in the pharynx, specifically, by measuring pharyngeal wall thickness and pharyngeal lu- men area in a sample of young versus older women. MRI scans of the neck were retrospectively reviewed from 60 women equally stratified into three age groups (20s, 60s, 70?). Four de-identified slices were extracted per scan for randomized, blinded analysis: one mid-sagittal and three axial slices were selected at the anterior inferior border of C2 and C3, and at the pit of the vallecula. Pixel-based measures of pharyngeal wall thickness and pharyngeal lu- men area were completed using ImageJ and then converted to metric units. Measures of pharyngeal wall thickness and pharyngeal lumen area were compared between age groups with one-way ANOVAs using Sidak adjustments for post- hoc pairwise comparisons. A significant main effect for age was observed across all variables whereby pharyngeal wall thickness decreased and pharyngeal lumen area increased with advancing age. Pairwise comparisons revealed sig- nificant differences between 20s versus 70? for all vari- ables and 20s versus 60s for all variables except those measured at C2. Effect sizes ranged from 0.54 to 1.34. Consistent with existing sacropenia literature, the pharyn- geal muscles appear to atrophy with age and consequently, the size of the pharyngeal lumen increases. Keywords Swallowing Á Deglutition Á Aging Á Pharynx Á Sarcopenia Introduction A vital mechanism for safe and efficient bolus propulsion through the pharynx during swallowing is through the ac- tion of the pharyngeal muscles. The pharyngeal constric- tors successively contract and relax around the bolus in a rostro-caudal sequence, propelling it toward and through the esophagus, while the longitudinal muscles of the pharynx facilitate simultaneous pharyngeal shortening, decreasing the distance the bolus must travel [1, 2]. Deficits in pharyngeal muscle contraction can result in post-swal- low residue [3–8] with increased aspiration risk once the pharynx reverts to a post-swallow breathing configuration [9, 10]. Sarcopenia, the age-related reduction of muscle mass and associated strength [11], is thought to play a role in presbyphagic changes to swallow function. Although re- search in sarcopenia of swallowing musculature has been primarily focused on the tongue [12–16], there is emerging evidence for similar changes in the pharynx. In 2001, Kendall and Leonard [17] employed two-dimensional lat- eral view videofluoroscopy to demonstrate delayed and S. M. Molfenter (&) Communicative Sciences & Disorders, Steinhardt, New York University, 665 Broadway, Room 934, New York, NY 10012, USA e-mail: smm16@nyu.edu M. R. Amin Á R. C. Branski Á J. D. Brumm Á S. A. Roof Otolaryngology-Head and Neck Surgery, New York University Langone Medical Center, New York, NY, USA M. Hagiwara Department of Radiology, New York University Langone Medical Center, New York, NY, USA C. L. Lazarus Otolaryngology-Head & Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA 123 Dysphagia DOI 10.1007/s00455-015-9602-9