Pharyngoesophageal swallowing disorders

Abstract

Pharyngoesophageal dysphagia is chiefly a disorder of the elderly. This review examines recent advances in the understanding of the normal physiology of oropharyngeal bolus transport. Techniques for the evaluation of symptomatic patients are discussed with an emphasis on the complementary nature of manometry and videoradiography. The technical limitations of manometry are detailed. Therapy for the condition is aimed at the underlying cause, and patients with neurologic deficits (largest subgroup of patients) should have a good response to myotomy provided they fulfill basic criteria. Surgery for Zenker's diverticulum is always necessary, and a short discussion of technique has been included.