[Radiological diagnosis of benign dysphagia]

In the diagnostic work-up of the benign dysphagia modern radiology must not only describe morphologic alterations but also has to keep in mind the great importance of motility disorders. Dysfunction of the esophagus can be assessed by fluoroscopy alone. The superior method to analyze the motility disorders of the oropharyngeal and pharyngo-esophageal transport is high-speed cineradiography at a frame-rate of 50 frames/sec on 35-mm film because of the very fast and complex patterns of motion during oropharyngeal deglutition, which occurs within only 0.5 to 0.7 sec. The upper esophageal sphincter turned out to play a very important role in many motility disorders of the pharynx and the esophagus, which often secondarily leads to permanent structural lesions. Examples are given, in which kinds of disorders cineradiography contributes to diagnosis and therapy. In some cases it turned out to be the method of first choice, as for example for aspiration.