Pharyngeal constrictor paresis in patients with dysphagia: a cineradiographic study

Among 250 patients examined by cineradiography because of dysphagia 25 were found to have a more or less pronounced paresis of the pharyngeal constrictor muscle. The paresis included all three portions of the muscle in six patients. A localised lesion was found in 19 patients and included the superior portion of the pharyngeal constrictor muscle in one patient, the middle portion in 16 patients and the middle and inferior portions in two patients. All 25 patients exhibited concomitant cineradiographic abnormalities, including impairment of the tilting down of the epiglottis, dysfunction of the cricopharyngeal muscle and retention of barium in the pharynx. With the aid of cineradiography it is possible to disclose an underlying pharyngeal constrictor paresis in about 10% of patients with dysphagia who are referred for radiographic examination. In most patients suffering from a localised pharyngeal paresis the diagnosis will be overlooked in a routine examination, but will be easily demonstrated with cineradiography.