Aspiration is frequently encountered in clinical medicine. In order to properly appreciate it, an adequate radiographic visualization of the pharynx during the second stage of swallowing is required. This is demonstrated best on the lateral view. In some cases, however, routine conventional procedures are often found inadequate because of the rapid sequence of events in the region during deglutition. For this reason, it may be helpful to use cinefluorographic analysis in obtaining a detailed information of the mechanisms involved in this phenomenon.
This phenomenon results from multiple causes, but it is possible to classify them into two main groups, local structural lesions and neurogenic diseases. In these lesions, which block mechanically the adequate closure of the laryngeal aperture or inhibit functionally the normal closing actions of the aspiration barrier, some of barium are aspirated. Aspiration may also occur if there is prolonged stasis and pooling of barium in the pharynx, because barium may overflow the aditus.
It should be pointed out that this phenomenon is frequently accompanied with other radiographic abnormalities. They consist of: (1) hesitancy in initiating a swallow; (2) asymmetrical deglutition; (3) pharyngeal laxity; (4) pharyngeal stasis; (5) return of barium from the oropharynx to the oral cavity; (6) nasal regurgitation; (7) abnormalities of the upper esophageal sphincter relaxation. When this sign is found along with these functional disorders of deglutition, and if neurogenic disorders can be excluded, development of local structural lesions involving the pharynx, larynx and cervical esophagus is strongly suspected.
