PubMed · 5447108
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O Mattsson. 1970. Cineroentgen equipment for small objects.. https://doi.org/10.1177/028418517001000108
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The purpose of this study was to given an introduction to the radiological evaluation of deglutition. The symptoms leading to videofluoroscopic investigation of swallowing are explained. The examination has to be tailored to the patient's symptoms. Each film scene depicts a characteristic patient position, a particular kind of contrast material and a certain amount. A systematic approach to analyze video films of deglutition and knowledge of the normal and abnormal swallowing functions are mandatory.
This paper explains the differential diagnosis of neurological dysphagia. Special groups of diseases are described that can only be assessed by dynamic recording modalities like videofluoroscopy and high-speed cineradiography. The need for dynamic recording results from the physiological data of deglutition. The act of deglutition lasts only 0.7 s, but requires the well-coordinated action of 5 cranial nerves and 26 muscle groups. For a systematic analysis of the underlying neurological disease a precise description of possible pathological single observations from the oral cavity to the cardia is offered to the radiologist. Important hints concerning possible "pitfalls" due to non-neurologically caused pharyngoesophageal motility disturbances are given. Although dynamic recording does not always allow the precise diagnosis of the underlying neurological disease, it enables us to classify the motor disturbances and leads to distinct "groups of disease." Thus, dynamic recording of deglutition is of crucial importance for further conservative or functional surgical treatment of the dysphagic patient.
Although adenotonsillectomy is usually considered a minor operation, numerous uncommon but severe complications have been described. Even tonsillectomy alone can cause velopharyngeal insufficiency (VPI). We describe two cases in which severe VPI was noted after palatine tonsillectomy was performed because of recurrent peritonsillar abscesses. The patients underwent clinical examination, nasalance measurements, videonasopharyngoscopy and videofluoroscopy. Findings in both patients were consistent with lesions of branches of the vagus and glossopharyngeal nerves through lingual rami, while one of the patients probably also had a lesion of the hypoglossal nerve. Endoscopic and videofluoroscopic examinations demonstrated essential differences in the patients' preoperative state of velopharyngeal anatomy. Findings demonstrate the value of careful postoperative endoscopic and videofluoroscopic examination in cases with VPI after tonsillectomy to identify factors affecting subsequent VPI and to design possible treatment.