Radiographic techniques and interpretation of abnormal swallowing in adult and elderly patients.

The radiologic evaluation of oropharyngeal dysfunction requires interpretation of observed morphodynamics and bolus movements. This can be facilitated if a simplified biomechanical approach is used to understand basic physiology. Oral stage activity can be described as a lingual delivery pump and pharyngeal stage activity as a glossopharyngeal propulsion pump. Bolus misdirection into the airway is more often due to oral rather than pharyngeal abnormalities and is frequently inconsistent with regard to timing and degree. The video-deglutition examination is still a relatively new diagnostic study and its purpose, indications, and criteria for patient selection should be clearly understood.