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Congress: ECR25
Poster Number: C-18292
Type: Poster: EPOS Radiologist (educational)
Authorblock: F. J. Azpeitia Arman, R. M. Lorente Ramos, A. I. Rubio, J. Azpeitia Hernandez, A. Muñoz Hernandez, E. Barcina García, M. Juan Porter, P. Gete García; Madrid/ES
Disclosures:
Francisco Javier Azpeitia Arman: Nothing to disclose
Rosa Maria Lorente Ramos: Nothing to disclose
Ana Inés Rubio: Nothing to disclose
Javier Azpeitia Hernandez: Nothing to disclose
Araceli Muñoz Hernandez: Nothing to disclose
Elena Barcina García: Nothing to disclose
Maria Juan Porter: Nothing to disclose
Pilar Gete García: Nothing to disclose
Keywords: Head and neck, Fluoroscopy, Barium meal, Eating disorders
Learning objectives To describe the normal anatomy of the pharyngoesophageal segment (PES). To analyze the normal physiology of the upper esophageal sphincter (UES) To propose a systematic approach for the study of pathology of the pharyngoesophageal segment. To illustrate common and uncommon imaging findings in videofluoroscopic swallow study (VFSS). To describe recommendations and rehabilitative strategies based on VFSS by evaluating the effectiveness of postures, maneuvers, bolus modifications, and sensory enhancements in improving swallowing safety and efficiency.
Read more Background The pharyngoesophageal segment (PES) is one of the only regions of the swallowing mechanism that can be modified with therapy and surgery.The Videofluoroscopic Swallow Study (VFSS) is the gold-standard tool for diagnosing PES dysfunction.A systematic approach to PES analysis ensures a comprehensive assessment of dysfunction.There are different objective measures to study the PES pathology: the pharyngeal constriction ratio (PCR), UES opening diameter, Determination of the PES opening dimensions, UES closure, measurement of the cricopharyngeus bar to distinguish between obstructive and...
Read more Findings and procedure details A.- PHARYNGOESOPHAGEAL SEGMENT (PES)/UPPER ESOPHAGEAL SPHINCTER (UES)1.- DefinitionThe upper esophageal sphincter (UES) is a 2.5–4.5 cm manometric high-pressure zone located between the pharynx and esophagusBecause of its location, this region has also been referred to as the pharyngoesophageal segment (PES)The cricopharyngeus muscle (CPM) makes up only one component of the PES.The CPM is not synonymous with the UES and PES [fig 1]  2.- Anatomic landmarks [fig 2]  3.- PES´s PhysiologySwallowing relies on the proper and timely opening of the pharyngoesophageal segment (PES). This opening is...
Read more Conclusion The VFSS is the current gold standard diagnostic test for the evaluation of the PES. It is crucial for a comprehensive dysphagia assessment as it objectively assesses the interaction between airway protection, laryngohyoid elevation, lingual and pharyngeal contractility, and PES opening.A comprehensive radiological assessment of the PES must include both qualitative evaluation and quantitative measures to monitor treatment progress effectively. Furthermore, an Esophagram is recommended for all patients with PES dysfunction.Residue, decreased pharyngeal clearance, and inadequate opening of the PES...
Read more References Javier Azpeitia Armán, Rosa M. Lorente-Ramos, Pilar Gete García, and Teresa Collazo Lorduy Videofluoroscopic Evaluation of Normal and Impaired Oropharyngeal Swallowing RadioGraphics 2019 39:1, 78-79 Jaffer NM, Ng E, Au FW, Steele CM. Fluoroscopic evaluation of oropharyngeal dysphagia: anatomic, technical, and common etiologic factors. AJR 2015; 204:49–58 Gore RM, Levine MS. Structural abnormalities of the pharynx. In: Gore RM, Levine MS. Textbook of gastrointestinal radiology, 3rd ed. New York, NY: Saunders Elsevier, 2008 Rosenbek JC, Robbins J, Roecker EV, et al. A penetration aspiration scale. Dysphagia 1996;11:93-98. Tessa A. Goldsmith, Allison S....
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