The clinical and radiological approach to dysphagia

Abstract

The intention of this chapter is to introduce a multidisciplinary diagnostic workup, and, in particular, to present a practical and structured radiological approach to patients with dysphagia. Swallowing disorders are common and affect the quality of life in a large number of patients across all ages, with a prevalence of 30–40% in independently living older people and up to 60% in institutionalized older patients (Baijens 2016). The swallowing tract crosses many anatomic regions. Liquid and solid foods have to be transported properly from the oral cavity into the pharynx and through the esophagus into the stomach. Thus, a wide variety of diseases may affect deglutition, necessitating a multidisciplinary workup of dysphagic patients. Videofluoroscopy (VF) is the method of choice with which to investigate the whole swallowing tract in a “one-stop-shop” fashion. The dynamic recording of deglutition can depict pathologic findings of morphology and function, as well as form a basis upon which to determine the necessity for and type of further specialized workup.