Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
J Oral Rehabil. 2024 Jul;51(7):1193-1201. doi: 10.1111/joor.13686. Epub 2024 Apr 3.
Upper oesophageal sphincter (UES) serves as an important anatomical and functional landmark during swallowing. However, the precise UES location before and during swallowing has not been well established.
This study aimed to determine upper oesophageal sphincter (UES) location and displacement during swallowing accounting for sex, age, and height in healthy adults using 320-row area detector computed tomography (320-ADCT).
Ninety-four healthy adults (43 males; 22-90 years) underwent 320-ADCT scanning while swallowing one trial of 10 mL honey thick barium. UES location at bolus hold and at maximum displacement and vertical displacement during swallowing were identified using the coordinates and the section classification of vertebrae (VERT scale). The differences and correlations of UES location and distance in terms of sex, age, and height were analysed using Mann-Whitney U test and Spearman's correlation coefficient.
UES locations at bolus hold and at maximum displacement were significantly lower and UES vertical displacement was significantly larger in males than in females (p < .001). UES location at bolus hold became lower with increasing age (r = -.312, p = .002), but the negative correlation was low at maximum displacement (r = -.230, p = .026), resulting in larger vertical distance with ageing. UES locations showed high negative correlation at bolus hold with height (r = -.715, p < .001), and showed moderate negative correlation at maximum displacement with height (r = -.555, p < .001), although this effect was unclear when analysed by sex.
Males showed lower UES location and larger displacement than females. The impact of age was evident with lower location before swallowing and larger displacement during swallowing. Differences observed by sex were not completely explained by using the VERT scale to adjust for height.
食管上括约肌（UES）是吞咽过程中的一个重要解剖学和功能标志。然而，UES 在吞咽前后的确切位置尚未得到很好的确定。
本研究旨在使用 320 排容积 CT（320-ADCT）确定健康成年人吞咽时食管上括约肌（UES）的位置和位移，并考虑到性别、年龄和身高的影响。
94 名健康成年人（43 名男性；22-90 岁）吞咽 10ml 蜂蜜钡剂时进行 320-ADCT 扫描。使用椎骨坐标和节段分类（VERT 标度）确定UES 在吞咽时的钡剂保持位置、最大位移位置和垂直位移位置。使用 Mann-Whitney U 检验和 Spearman 相关系数分析 UES 位置和距离在性别、年龄和身高方面的差异和相关性。
男性的UES 位置在钡剂保持时更低，最大位移时更大，UES 垂直位移也更大（p<0.001）。UES 位置在钡剂保持时随年龄增长而降低（r=-0.312，p=0.002），但在最大位移时的负相关较低（r=-0.230，p=0.026），导致随着年龄的增长，UES 垂直距离增大。UES 位置在钡剂保持时与身高呈高度负相关（r=-0.715，p<0.001），在最大位移时与身高呈中度负相关（r=-0.555，p<0.001），尽管按性别分析时这种影响并不明显。
男性的 UES 位置较低，位移较大。吞咽前位置较低，吞咽时位移较大，这表明年龄的影响明显。性别差异不能完全用 VERT 标度来调整身高来解释。
