Learning objectives
1- Anatomy of the aero-digestive tract.
2-Recognize the clinical presentation of dysphagia subtypes.
3-Review indications and uses of Barium Swallow Study.
4-Discuss pertinent imaging findings of normal anatomy and common pathology of the upper aerodigestive tract and esophagus in Barium Swallow Study.
Background
Anatomy:
The pharynx is the superior part of the alimentary canal,
located posterior to the nasal and oral cavities and extending inferiorly past the larynx1.
The pharynx can be divided into three anatomic regions: nasopharynx,
oropharynx and hypopharynx.
1- Nasopharynx is located posterior to the nose and superior to the soft palate and uvula.
It contains the pharyngeal tonsils,
the opening of the eustachian tubes and the posterior aspect of the inferior turbinates of the nasal cavity5.
2- Oropharynx is located posterior to the mouth...
Findings and procedure details
I.
Oropharyngeal Functional Abnormalities
The most common cause of oropharyngeal functional abnormalities are neurologic causes including cerebrovascular accidents,
multiple sclerosis,
alzheimer,
amyotrophic lateral sclerosis,
myasthenia gravis among others.
A.
Cricopharyngeal Dysfunction
The upper esophageal sphincter main component is the cricopharyngeal muscle,
it must completely relax for the upper esophageal sphincter (UES) to be able to open and let the bolus pass.
Cricopharyngeal dysfunction refers to incomplete relaxation or an early closure of the muscle that can cause a dilatation of the proximal esophagus and trapping...
Conclusion
Dysphagia,
also known as difficulty swallowing,
is a common diagnosis that can be the result of multiple etiologies.
Barium Swallow is the gold standard for the diagnosing dysphagia due to its ability to evaluate the esophageal anatomy and motility.
Dysphagia can be classified as structural or functional using the patient’s history and barium swallow findings.
As the population ages neuromuscular and structural causes of dysphagia increase in prevalence,
reason why radiologist should be familiarized with the imaging findings of this etiologies on barium swallow.
Knowing...
References
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Baker,
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Barium Esophagram Does It Have a Role in Gastroesophageal Reflux Disease?Gastroenterology Clinics,43,
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Goldman,
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I.
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