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 can result in post-deglutitory aspiration. Fluoroscopy’s ability to provide objective insights into the interactions between airway protection, laryngeal elevation, tongue and pharyngeal movements, and PES opening underpins its importance in a thorough dysphagia evaluation.