Otolaryngologic Changes That Occur With Aging
The natural changes that take place in the structures and functions of the EAR, NOSE, THROAT, and MOUTH as a person grows older. Age-related changes manifest in late childhood, as facial structures elongate, and again in the sixth decade and beyond, as some diminishment of function, particularly sensory perception, develops.
Otolaryngologic Changes in Late Childhood
Though the senses of hearing, taste, and smell are fully developed by about one month of age, changes in facial structure later in childhood alter some aspects of function. The rounded facial structures of the young child begin to change around age five or six and continue into early ADOLESCENCE. The head elongates, expanding the nasal and oral passages. The eustachian tubes lengthen and angle downward, improving their ability to remain patent (open and clear of congestion). The arch of the palate (roof of the mouth) flattens, and the permanent TEETH come in. Control of the tongue, lips, and other muscular structures of the face and neck improves. These changes facilitate the ability to form words. By late childhood, many difficulties with speech begin to resolve. Continued development of the brain’s temporal lobe, which processes hearing and language as well as taste and smell, expands and refines speech capabilities and sensory interpretations. Whereas a child may perceive a flavor as “chocolate,” an adult will discern that same flavor in terms of multiple descriptors.
Otolaryngologic Changes in Late Life
In healthy adults, sensory perceptions, balance, and language capacity remain intact well into the sixth or seventh decade. Beyond this point, many people experience alterations in taste and smell, and particularly hearing. Health conditions that become more prevalent with age, such as STROKE and PARKINSON’S DISEASE, also affect sensory functions as well as swallowing and speech.
Taste cells, located within taste buds, are the only sensory cells that regenerate, and they do so regularly throughout life. By midlife the rate of regeneration slows, and a person at age 60 has about half as many taste cells as at age 30. The more significant influence on the perception of taste, however, is the loss of olfactory receptors in the nose. The body does not replenish these specialized sensory cells, which detect thousands of odors in comparison to the four basic qualities the sense of taste detects. By age 70 there are about a third as many olfactory receptors as at age 30. These changes influence a person’s interest in food and desire to eat, which commonly becomes a reason for inadequate nutrition and diet in the elderly. As well, the loss of teeth due to DENTAL CARIES (cavities) and gum diseases such as PERIODONTAL DISEASE, and decreased saliva production, diminish the ability to chew, further restricting food choices.
The clinical term for age-related HEARING LOSS is PRESBYCUSIS. The HAIR cells within the COCHLEA, which respond to the frequencies of the vibrations that pass into the inner EAR, are extraordinarily sensitive. By the sixth or seventh decade of life, the fibers of the hair cells, particularly those sensitive to high frequency vibrations, break and experience other damage. This causes loss of the ability to register sounds in those frequencies, which manifests as hearing loss. As these are the frequencies of normal conversation, the loss, though gradual, becomes apparent. Hearing aids that amplify sound waves in these frequencies can help restore the function of hearing. OTOSCLEROSIS (fusion of the auditory ossicles, the tiny bones of the inner ear) and damage to tissues that results from impaired blood circulation (caused by ATHEROSCLEROSIS, for example) also diminish hearing.
Otolaryngologic Changes in Late Childhood
Though the senses of hearing, taste, and smell are fully developed by about one month of age, changes in facial structure later in childhood alter some aspects of function. The rounded facial structures of the young child begin to change around age five or six and continue into early ADOLESCENCE. The head elongates, expanding the nasal and oral passages. The eustachian tubes lengthen and angle downward, improving their ability to remain patent (open and clear of congestion). The arch of the palate (roof of the mouth) flattens, and the permanent TEETH come in. Control of the tongue, lips, and other muscular structures of the face and neck improves. These changes facilitate the ability to form words. By late childhood, many difficulties with speech begin to resolve. Continued development of the brain’s temporal lobe, which processes hearing and language as well as taste and smell, expands and refines speech capabilities and sensory interpretations. Whereas a child may perceive a flavor as “chocolate,” an adult will discern that same flavor in terms of multiple descriptors.
Otolaryngologic Changes in Late Life
In healthy adults, sensory perceptions, balance, and language capacity remain intact well into the sixth or seventh decade. Beyond this point, many people experience alterations in taste and smell, and particularly hearing. Health conditions that become more prevalent with age, such as STROKE and PARKINSON’S DISEASE, also affect sensory functions as well as swallowing and speech.
Taste cells, located within taste buds, are the only sensory cells that regenerate, and they do so regularly throughout life. By midlife the rate of regeneration slows, and a person at age 60 has about half as many taste cells as at age 30. The more significant influence on the perception of taste, however, is the loss of olfactory receptors in the nose. The body does not replenish these specialized sensory cells, which detect thousands of odors in comparison to the four basic qualities the sense of taste detects. By age 70 there are about a third as many olfactory receptors as at age 30. These changes influence a person’s interest in food and desire to eat, which commonly becomes a reason for inadequate nutrition and diet in the elderly. As well, the loss of teeth due to DENTAL CARIES (cavities) and gum diseases such as PERIODONTAL DISEASE, and decreased saliva production, diminish the ability to chew, further restricting food choices.
The clinical term for age-related HEARING LOSS is PRESBYCUSIS. The HAIR cells within the COCHLEA, which respond to the frequencies of the vibrations that pass into the inner EAR, are extraordinarily sensitive. By the sixth or seventh decade of life, the fibers of the hair cells, particularly those sensitive to high frequency vibrations, break and experience other damage. This causes loss of the ability to register sounds in those frequencies, which manifests as hearing loss. As these are the frequencies of normal conversation, the loss, though gradual, becomes apparent. Hearing aids that amplify sound waves in these frequencies can help restore the function of hearing. OTOSCLEROSIS (fusion of the auditory ossicles, the tiny bones of the inner ear) and damage to tissues that results from impaired blood circulation (caused by ATHEROSCLEROSIS, for example) also diminish hearing.
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