Age-related changes in the hyoepiglottic ligament: functional implications based on histopathologic study

Sawatsubashi, Motohiro; Umezaki, Toshiro; Kusano, Kenichiro; Tokunaga, Osamu; Oda, Masamichi; Komune, Shizuo

doi:10.1016/j.amjoto.2009.08.003

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 31, Issue 6 , Pages 448-452, November 2010

Age-related changes in the hyoepiglottic ligament: functional implications based on histopathologic study☆

Motohiro Sawatsubashi, MD, PhD
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
- Corresponding author. Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyushu University, Fukuoka 812-8582, Japan. Tel.: +81 92 642 5668; fax: +81 92 5685.
Toshiro Umezaki, MD, PhD
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
Kenichiro Kusano, MD, PhD
- Department of Pathology, Saga Medical School, Saga, Japan
Osamu Tokunaga, MD, PhD
- Department of Pathology, Saga Medical School, Saga, Japan
Masamichi Oda, MD, PhD
- ENT Surgery Center, Yuai-Kai Oda Hospital Kashima, Saga, Japan
Shizuo Komune, MD, PhD
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyushu University, Fukuoka, Japan

Received 21 April 2009 published online 12 October 2009.

Abstract

Purpose

The study aimed to identify age-related changes in the hyoepiglottic ligament associated with function of the epiglottis during swallowing and respiration.

Materials and Methods

Normal postmortem laryngeal tissue samples were obtained at autopsy from 20 individuals with no history of laryngeal disease. The subjects were divided into 2 groups: those aged 81–91 years (elderly group, n = 11) and those aged 31–48 years (non-elderly group, n = 9). Specimens were subjected to Elastica van Gieson and hematoxylin-eosin staining, and characteristics of the hyoepiglottic ligament were compared between groups.

Results

The hyoepiglottic ligament extended from the epiglottis to both lingual muscles and the hyoid bone (pars lingualis and pars hyoideus). The numbers of muscle fibers (P < .001), collagenous fibers (P < .01), and elastic fibers (P < .001) were significantly decreased in the elderly group in comparison to those in the non-elderly group.

Conclusion

Age-related changes in the hyoepiglottic ligament appear to be associated with aspiration, obstructive sleep apnea syndrome, and acquired laryngomalacia in the elderly.