[Differential diagnosis of dysphagia]

The symptom dysphagia is defined and an interdisciplinary team approach emphasized. A step like diagnostic approach in oropharyngeal dysphagia is described, including transnasal pharyngo-laryngo-fiber endoscopy, videofluoroscopy and the "modified barium swallow." First, all of the organic changes causing oropharyngeal dysphagia must be recognized, both "typical ENT diseases" and malignant tumors of the oropharynx and hypopharynx, which are usually diagnosed only at an advanced stage. Of particular interest is postoperative dysphagia with or without aspiration. If there is no evidence of an organic cause in the field of otorhinolaryngology, in making a differential diagnosis dysfunction of the upper esophageal sphincter and a "globus pharyngis" have to be ruled out.