Imaging of the pharynx and esophagus

The year 1991 was a year of innovation, with interesting papers published in the imaging as well as the medical and surgical literature. Several reports described novel techniques using transcutaneous ultrasound to evaluate the swallowing mechanism; another used CT and ultrasound of the neck for staging esophageal carcinoma. The new field of endoscopic ultrasound was again a subject of much investigation and was compared with CT in the staging of esophageal cancer. One study suggested that endoscopic ultrasound was superior to CT in staging esophageal cancer whereas another found that endoscopic ultrasound had an accuracy rate of only 59% in detecting local invasion. MR imaging and CT were reevaluated for staging esophageal carcinoma using criteria that were modified slightly from previous techniques. These new criteria simplified the detection of aortic and pericardial invasion and staged esophageal carcinoma accurately. The definition of "normal" was refined this year. For instance, in a study of swallowing in asymptomatic and presumably normal elderly individuals, a number of findings were encountered that are considered abnormal in the younger patient. Another study documents normal swallowing patterns in the infant. Other papers provided refinements in radiographic examination techniques as well as excellent reviews of anomalies, esophagitis, and the management of esophageal foreign bodies. The review is divided into two sections that discuss the pharynx and the esophagus.