Hurtado-Oliva Javier, Núñez-Miranda Lucy, Zwart Aniek T, Vister Jeroen, Plaat Boudewijn E C, Steenbakkers Roel J H M, van der Hoorn Anouk, Wegner Inge, Halmos Gyorgy B
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO box 30.001, Groningen, 9700RB, The Netherlands.
Departamento de Fonoaudiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Eur Arch Otorhinolaryngol. 2025 Jan 25. doi: 10.1007/s00405-025-09207-0.
Sarcopenia, characterized by loss of skeletal muscle mass (SMM) and strength, often leads to dysphagia in the elderly. This condition can also worsen treatment outcomes in head and neck cancer (HNC) patients, who are susceptible to swallowing difficulties. This study aimed to establish the correlation between swallowing muscle mass (SwMM) and SMM in HNC patients.
Data from 157 HNC patients in the OncoLifeS biobank of the University Medical Center Groningen were analyzed using pre-treatment neck CT scans. The SwMM was assessed by the cross-sectional area (CSA) of the tongue complex muscles (TCM), and SMM was indicated by the skeletal muscle index (SMI), calculated from corrected CSA at the third lumbar vertebra (L3). Correlations between SwMM and SMM were analyzed using Pearson or Spearman tests, and multivariable linear regression with SMI as dependent variable was performed.
SwMM was moderately correlated with SMI (r = 0.600, p < 0.001), CSA at C3 (r = 0.538, p < 0.001), and CSA at L3 (r = 0.651, p < 0.001). The CSA at C3 strongly correlated with SMI (r = 0.871, p < 0.001). In multivariable regression analysis, age, sex, and weight were strong predictors of SMI, while the TCM area was a less robust predictor (p = 0.059). Models with CSA at C3 and L3 showed all variables as significant predictors (p < 0.001).
Although SwMM was significantly correlated with SMI and holds clinical utility, it is not strong enough to be considered interchangeably with C3 for predicting SMI, suggesting that swallowing muscles represent a different entity than skeletal muscles and not reflect accurately the general muscle mass.
以骨骼肌质量（SMM）和力量丧失为特征的肌肉减少症，常导致老年人吞咽困难。这种情况也会使头颈部癌（HNC）患者的治疗结果恶化，这些患者易出现吞咽困难。本研究旨在确定HNC患者吞咽肌肉质量（SwMM）与SMM之间的相关性。
使用格罗宁根大学医学中心OncoLifeS生物样本库中157例HNC患者的治疗前颈部CT扫描数据进行分析。通过舌复合肌（TCM）的横截面积（CSA）评估SwMM，SMM用骨骼肌指数（SMI）表示，该指数由第三腰椎（L3）处校正后的CSA计算得出。使用Pearson或Spearman检验分析SwMM与SMM之间的相关性，并进行以SMI为因变量的多变量线性回归分析。
SwMM与SMI（r = 0.600，p < 0.001）、C3处的CSA（r = 0.538，p < 0.001）和L3处的CSA（r = 0.651，p < 0.001）呈中度相关。C3处的CSA与SMI高度相关（r = 0.871，p < 0.001）。在多变量回归分析中，年龄、性别和体重是SMI的强预测因素，而TCM面积是较弱的预测因素（p = 0.059）。包含C3和L3处CSA的模型显示所有变量均为显著预测因素（p < 0.001）。
虽然SwMM与SMI显著相关并具有临床实用性，但在预测SMI方面，其强度不足以与C3处的CSA互换使用，这表明吞咽肌肉代表与骨骼肌不同的实体，不能准确反映总体肌肉质量。
