![]() Swallowing involves the close cooperation of many muscles, six cranial nerves (trigeminal, facial, glossopharyngeal, vagus, spinal branch of accessory, and hypoglossal) and the first, second, and third cervical nerves (through the ansa cervicalis). Such extensive examination is necessary because the level of symptoms is not a reliable indicator of the site of the abnormality, several lesions could be causing dysphagia, and esophageal disease may result in pharyngeal disease. The entire swallowing chain must be examined. In addition, an abnormality such as a web or laryngeal penetration may be visible on only one or two frames at 30 frames/s. ![]() 1-4 cm/s), which is why dynamic imaging is essential when examining the pharynx. Pharyngeal contraction occurs much faster than esophageal contraction (12-25 cm/s vs. Two important principles must be considered when reviewing pharyngeal studies:ĭynamic imaging is vital. Any lack of movement or abnormalities indicating compensation or decompensation must be noted. Esophageal peristalsis should also be evaluated, but discussion of this subject is beyond the scope of this chapter.įamiliarity with the anatomy, radiographic anatomy, and physiology of the pharynx and related structures is a necessity for abnormalities to be appreciated. With these capabilities, the movement of individual structures can be analyzed, first in isolation and then in combination with other structures, including the tongue, palate, epiglottis, hyoid bone, larynx, and cricopharyngeus. In reviewing the pharyngeal swallow, the slow motion, reverse, and stop-frame capabilities of videofluorography are essential. Analysis of the Functional Aspects of Swallowing
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