Topographic representation of the pharyngoesophageal segment during swallowing

Motility of the pharyngoesophageal segment (PES) was monitored by cineradiography (50 frames a second) during barium swallow and analyzed by a computerized topographic mapping of sagittal wall motion. Through measurement of wall displacement on 20 consecutive levels of the PES, distention, contraction, and peristalsis were studied. Topographic mapping of three patients with normal PES motility, delayed opening of the cricopharyngeus, and incomplete opening of the cricopharyngeus, was performed. These topographic mappings show that "narrowing" at the level of the cricopharyngeus reflects expansion of the hypopharynx and cervical esophagus around the cricopharyngeus, rather than a true narrowing. In addition, analysis of wall motion demonstrated that abnormality of the circopharyngeus is often associated with abnormality of wall motion in the adjoining hypopharynx and cervical esophagus. Thus, topographic mapping of the cricopharyngeus is of value because it enables detailed analysis of wall motion during various pathologic conditions.