[Functional and morphological changes in the pharynx in achalasia and diffuse esophageal spasm]

Area of Science:

• Gastroenterology
• Radiology
• Otolaryngology

Background:

• The pharynx and esophagus function as a unit, necessitating integrated diagnostic approaches.
• Achalasia and diffuse esophageal spasm can be associated with pharyngeal dysfunction.

Purpose of the Study:

• To investigate the incidence of pharyngeal disorders in patients with achalasia or diffuse esophageal spasm.
• To evaluate the utility of high-speed cineradiography in diagnosing pharyngeal dysphagia.

Main Methods:

• Cineradiography was employed in 73 patients with achalasia or diffuse esophageal spasm.
• Functional and morphological pharyngeal disorders were assessed.
• Manometry was used for comparison, particularly in the upper esophageal sphincter region.

Main Results:

• A significantly increased incidence of pharyngeal morphological and functional disorders was observed.
• Functional pharyngeal alterations were often missed by conventional fluoroscopy.
• High-speed cineradiography demonstrated high temporal and spatial resolution, proving valuable for analyzing pharyngeal dysphagia.
• Manometry showed good correlation in the tubular esophagus but was unreliable for the upper esophageal sphincter.
• Commonly observed pharyngeal abnormalities included webs, diverticula, and asymmetry.

Conclusions:

• Pharyngo-esophageal interaction is critical in functional radiodiagnosis.
• High-speed cineradiography is superior to conventional fluoroscopy for detecting functional pharyngeal disorders.
• Pharyngeal abnormalities are frequently associated with achalasia and diffuse esophageal spasm, impacting diagnosis and management.