To improve the radiologist’s understanding of the videofluoroscopy swallow study (VFSS) in the assessment of oropharyngeal dysphagia. To appreciate the indications and technical acquisition of the examination as well as the fluoroscopic anatomy and common pathologies that may require radiologist input and diagnosis.
Swallowing is a complex, continuous multiphase process that spans the oral cavity to the stomach. Associations between oropharyngeal and oesophageal abnormalities are poorly understood but well documented[1-3]. Despite the close association, assessment of swallowing has been dichotomised into separate oropharyngeal and oesophageal evaluation by way of VFSS or oesophageal barium swallows in fluoroscopy with the speech pathologist performing the former and the radiologist performing the latter.
Speech pathologists have expertise in diagnosing physiological abnormalities, however not infrequently they will either suspect anatomical pathology that...
Imaging findings OR Procedure details
Define physiological cause of swallow symptoms
Determine aspiration risk
Prescribe safe diet and fluid consistencies including compensatory strategies
Determine rehabilitation practices
Evaluate change in swallow function as an objective outcome measure
Frame rates (pulses/sec):
Enhanced VFSS images improves accuracy and practitioner reliability in detecting the degree of aspiration or penetration[5,6].
Fluids = 30 frames per second ·Solids = 15 frames per second ·AP plane = 4 frames per second*
*note - standard protocol may vary between departments.
Mean effective dose...
The VFSS is an important assessment tool for oropharyngeal dysphagia. Radiologist understanding and interpretability of common pathology can improve patient recommendation and management.
Nothing to disclose
1. Jones B, Ravich W, Donner M, Kramer S, Hendrix T. Pharyngoesophageal interrelationships: observations and working concepts. Gastrointest Radiol. 1985;10:225-233.
2. Triadafilopoulos G, Hallstone A, Nelson-Abbott H, Bedinger K. Oropharyngeal and esophagealinterrelationships in patients with nonobstructive dysphagia. Dig Dis Sci. 1992;37:551-557.
3. Gullung J, Hill E, Castell D, Martin-Harris B. Oropharyngeal and esophageal swallowing impairments: their association and the predictive value of the modified barium swallow impair- ment profile and combined multichannel intraluminal impedance-esophageal manometry. Ann Otol Rhinol Laryngol. 2012;121:738-745.
4. Watts S, Gaziano...