Oropharyngeal fluorography is a simple method with high reliability for checking the degree, cause and locus of dysphagia, because we can observe every part of the process of swallowing. This examination is also useful to detect the organic or functional dysfunction of the oral cavity, pharynx, and esophagus.
This paper will describe oropharyngeal fluorography for the image diagnosis of dysphagia.
Deglutition time is too short to evaluate all of the processes of swallowing precisely in a single moment. Examinations do not always reflect usual deglutition conditions because the contrast media used in examinations are different from usual diet contents.
We should pay attention especially to the following in examining the patient who has aspiration.
1. We have to select contrast media carefully, because lower respiratory tract damage occurs using inappropriate media such as Barium or high osmotic substance.
2. We should only do a few trials of swallowing in patients having severe aspiration that might cause respiratory damage.
3. It is difficult to take a X-ray photo in proper timing with deglutition especially in functional dysphagia.
Recording on video tape is preferable for this type of examination, especially in cases having aspiration or some disorder. We could analyze the details of organic or functional disorders with this system by playing back in slow motion many times.
There are limits in evaluating the swallowing function using only oropharyngeal fluorography. It is possible that a more correct evaluation of the swallowing function will be produced in combination with electro-myogram and intrapharyngeal manometry.
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