Upper esophageal sphincter and pharyngeal function and oropharyngeal (transfer) dysphagia

Through the application of videoradiography and solid-state manometry, much insight has been gained into the pathophysiology of oropharyngeal dysphagia, and considerable guidance has been provided toward appropriate therapies for the multitude of conditions causing this symptom. As noted earlier, a multidisciplinary approach to these patients often provides the most effective diagnosis and treatment regimen. In the diagnostic evaluation, barium videoradiography and solid-state intraluminal manometry should be considered as complementary procedures, with each providing important aspects of the overall assessment of the swallowing mechanism. It is important to note that controlled evaluations of the various treatment modalities are lacking and that therapy, although directed by information provided by the radiographic and manometric assessment, is primarily empiric. Despite this limitation, great strides have been made in the overall management of these patients during the past decade.