Laryngeal dynamics.

Laryngeal symptomatology is diverse and may be subtle. The barium swallow may be the first indication of abnormality and must be performed in a recorded mode since neurigenic dysphagia may be impossible to detect without the benefit of slow motion and replay. Inspiration, phonation, and the Valsalva maneuvers may give additional information in plain film, tomographic, laryngographic, or videofluoroscopic modes. They should be interpreted together and a specific functional abnormality determined if possible. The modified Valsalva and Mueller maneuvers, on the other hand, are means of evaluating anatomic variations, but provide little dynamic information. Neurologic and otolaryngologic consultation should be made for confirmation as required for patient care.