Abstract
Radiographic observations of deglutitory function were made in subjects complaining of abnormal sensation of the throat in order to evaluate possible changes.
Two hundred patients with the above complaints and 63 normal subjects were examined by 15-second serial radiography with a 30 cc barium swallow. Results were, 1) The dilated type and spastic type which are considered pathological were seen in 23% of the patients.
2) In patients with abnormal sensation, the esophageal passage time and evacuation time were all prone to protraction, and barium retention was frequently seen.
3) Patterns of esophageal passage time curves displayed by these subjects may be classified into 4 distinct types ; normal, slow, static and mixed. And it would be appropriate to add a dilated type to these 4 types.
4) As for evacuation of esophageal contents, achalasia-like findings were noted in only 3% of the patients whereas findings suggestive of transient, mild dysfunction of the cardia were frequent.
5) The esophageal function seems to be closely affected either by gastric tonicity or acidity but there was no evidence that its impairment is related to aging or to general autonomic nerve imbalance.
Pharmacodynamic tests revealed that cholinergic drugs tend to affect the lower segment of the esophagus whilst adrenergics are liable to affect the upper portion.
6) 43% of the patients showed radiographic evidence of abnormality in phase 2 of swallowing, where, except for 4 cases of true cricopharyngeal dysphagia, the abnormality was no more than a slight hypertonicity of the adit possibly reflecting prolonged passage of contents in the lower esophageal segment.
The findings obtained suggest involvement of the higher center in the development of esophageal hypertonia.
7) The authors discussed the clinical implication of the protracted passage of contents in the lower esophageal segment in approximately a half of subjects with abnormal sensation of the throat.
