-To remember the main anatomic and physiologic aspects of the swallowing process. -An approach to the videofluoroscopic swallowing examination technique, emphasizing on the choice of different contrast viscosities according to the indication of the study. -To provide a pictorial review of both physiological and pathological videofluoroscopic findings in each of the four swallowing phases.

Swallowing is a complex process which must accomplish two main objectives: transporting the food from the oral cavity to the oesophagus, and protecting the entrance of the airway while this transport occurs. The principal anatomical structures that take part on it are shown in the Fig. 1. The swallowing is divided into four stages(Fig. 2): Oral preparatory phase:The bolus is located in the oral cavity, between the tongue and the palate. The glossopharyngeal junction remains sealed so it cannot go into the pharynx. Oral propulsive...

Positioning and acquisition The patient is placed standing, in a lateral position. Following the experience of our centre the lateral projection is enough to achieve an optimal imaging of the structures in most of cases, therefore it is the only positioning included in our routine protocol. We reserve the oblique and anteroposterior projections for specific cases, for example when any asymmetries are suspected. We use a high image acquisition rate (30 images per second). In contrast to what it may seem, it has been reported...

-Swallowing is a four-phase divided process where a number of coordinated anatomical structures take part. -Videofluoroscopyis one of the basic pillarsforthe diagnosis of swallowing disorders, along with the clinical examination. -It gives us the chance to specify, besides many other important aspects, the concrete food viscositythat causes the swallowing disease. -It is essential to develop a complete report so that it can guide the clinical attitude.

Diagnóstico y tratamiento de la disfagia orofaríngea funcional. Aspectos de interés para el cirujano digestivo. Clavé P, Arreola V, Velasco M, Quer M, Castellví JM, Almirall J et al. Cir Esp 2007;82(2):62-76 Abordaje clínico de la disfagia orofaríngea: diagnóstico y tratamiento. Velasco MM, Arreola V, Clavé P, Puiggrós C Nutr Clín Med 2007;1(3):174-202 Oropharyngeal dysphagia: patophysiology and diagnosis for the anniversary issue of Diseases of the Esophagus. Logemann JA, Larsen K. Dis Esophagus2012 May;25(4):299-304. Evaluation and treatment of swallowing disorders.Logemann JA. 2nd ed. Austin, TX:...