Fluoroscopy Pharynx Dynamic and Static Imaging The evaluation of the pharynx with dynamic and static imaging evaluates swallowing function similar to the modified barium swallow. However, this examination typically does not involve a variety of barium consistencies, does not include an evaluation of therapeutic options, and does not evaluate the thoracic esophagus and gastric cardia. Static images aid in evaluation for structural abnormalities of the pharynx. CT Neck and Chest CT is usually not indicated in this clinical scenario because it does not assess oropharyngeal function. Esophageal Transit Nuclear Medicine Scan Scintigraphy is usually not indicated in this clinical scenario because it does not assess the oropharynx. Variant 2: Unexplained oropharyngeal dysphagia. Initial imaging. Patients with unexplained oropharyngeal dysphagia may need a more detailed barium study to determine the cause. Also, because abnormalities of the distal esophagus or gastric cardia can cause referred sensation of dysphagia in the upper chest or pharynx, the esophagus and gastric cardia should be evaluated in patients with pharyngeal symptoms, and a combined radiologic examination of the oral cavity, pharynx, esophagus, and gastric cardia is appropriate for patients with unexplained pharyngeal dysphagia. In patients with unexplained oropharyngeal dysphagia, the combination of videofluoroscopy and static images of the pharynx with an examination of the esophagus has a higher diagnostic value than either videofluoroscopy (such as a modified barium swallow) or static images (such as a biphasic or single-contrast esophagram) alone [17]. If a study is performed using solely static imaging, a biphasic study is preferable to a single-contrast barium swallow because of its superior depiction of mucosal processes. Fluoroscopy Single-Contrast Esophagram Double-contrast technique provides more superior mucosal detail compared with the single-contrast technique.
Dysphagia. Fluoroscopy Pharynx Dynamic and Static Imaging The evaluation of the pharynx with dynamic and static imaging evaluates swallowing function similar to the modified barium swallow. However, this examination typically does not involve a variety of barium consistencies, does not include an evaluation of therapeutic options, and does not evaluate the thoracic esophagus and gastric cardia. Static images aid in evaluation for structural abnormalities of the pharynx. CT Neck and Chest CT is usually not indicated in this clinical scenario because it does not assess oropharyngeal function. Esophageal Transit Nuclear Medicine Scan Scintigraphy is usually not indicated in this clinical scenario because it does not assess the oropharynx. Variant 2: Unexplained oropharyngeal dysphagia. Initial imaging. Patients with unexplained oropharyngeal dysphagia may need a more detailed barium study to determine the cause. Also, because abnormalities of the distal esophagus or gastric cardia can cause referred sensation of dysphagia in the upper chest or pharynx, the esophagus and gastric cardia should be evaluated in patients with pharyngeal symptoms, and a combined radiologic examination of the oral cavity, pharynx, esophagus, and gastric cardia is appropriate for patients with unexplained pharyngeal dysphagia. In patients with unexplained oropharyngeal dysphagia, the combination of videofluoroscopy and static images of the pharynx with an examination of the esophagus has a higher diagnostic value than either videofluoroscopy (such as a modified barium swallow) or static images (such as a biphasic or single-contrast esophagram) alone [17]. If a study is performed using solely static imaging, a biphasic study is preferable to a single-contrast barium swallow because of its superior depiction of mucosal processes. Fluoroscopy Single-Contrast Esophagram Double-contrast technique provides more superior mucosal detail compared with the single-contrast technique.