Stefano Doratiotto MD, Presenter: Nothing to Disclose

Simonetta De Giorgi MD, Abstract Co-Author: Nothing to Disclose

Massimo Pasian, Abstract Co-Author: Nothing to Disclose

Giovanni Morana MD, Abstract Co-Author: Nothing to Disclose

This study evaluated the clinical significance of pharyngeal stasis of contrast medium to predict aspiration in patients with dysphagia.  

With videofluoroscopy study pharyngeal stasis was found in 148 of 350 patients with swallowing disorders. The amount of residual contrast bolus in the valleculae or piriform sinuses was graded as mild, moderate, or severe. The frequency, type, and grade of aspiration were assessed.

Pharyngeal retention was caused by pharyngeal weakness or paresis in 143 of 148 patients. In 70 patients (65%) with pharyngeal retention, post deglutitive aspiration was found. Aspiration was more often found in patients who had other swallowing disorders such as incomplete laryngeal closure or impaired epiglottic tilting or the upper esophageal sphincter hypertonicity (p <0.05). Post deglutitive aspiration was diagnosed in 25% patients with mild, in 27% with moderate, and in 91% with severe pharyngeal retention (p < 0.05).

Post deglutitive aspiration is a frequent finding in patients with pharyngeal stasis, and the risk of aspiration increases significantly with the increase of residue. Functional abnormalities such as pharyngeal weakness, impaired closure of the larynx and the upper esophageal sphincter hypertonicity can contribute to aspiration. A videofluoroscopy swallowing study has proved an essential tool for the diagnosis of pharyngeal stasis.  

The airways aspiration is a frequent finding in patients with pharyngeal bolus retention, the videofluoroscopy study is the most effective method to highlight.

Doratiotto, S, De Giorgi, S, Pasian, M, Morana, G, Videofluoroscopy Swallowing Study in Patients with Pharyngeal Stasis of Contrast Medium.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002752.html