Videofluoroscopic Assessment of Swallowing

Abstract

Because radiographic techniques of evaluating the upper, striated-muscle portion of the esophagus differ significantly from those of evaluating the lower, smooth-muscle portion of the esophagus, a radiographic assessment of swallowing should be directed by the patient’s history. The history enables the examiner to focus on the anatomical segment that is most likely involved and to tailor the study accordingly. If the history suggests problems related to the upper esophagus, the patient will require rapid-sequence, cine-fluoroscopy of the oropharynx and hypopharynx with only a few spot films. In contrast, if the history suggests problems of the lower esophagus, then the patient will require cine-radiographic evaluation of swallows in the prone position to assess motility, and double-contrast spot films to detect anatomic abnormalities.