Learning Resources for Upper
Swallowing Disorders
Compiled and produced for the benefit of radiologists, clinicians, and individuals grappling with swallowing disorders.
Educational 3-D atlas and radiographic evaluation of superior swallowing muscles, nerves, and osseocartilaginous anatomy affected by oculopharyngeal muscular dystrophy, neuropathology, Eagle’s and superior thyroid cornu syndrome with patients perspective, for radiologists, clinicians and individuals affected by swallowing disorders.
Resources
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Swallowing
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Patient Participation
Read a personal patient participation story from Jenna G.
Losing the ability to swallow normally or dysphagia ranks as one of the highest functions by patients, that affects their quality of life. Currently it is estimated that there are over 9 million Americans suffering from dysphagia, likely to increase as dysphagia becomes more prevalent in aging populations, affecting up to 1 in 5 elderly adults. The complex act of swallowing involving both the oropharynx and esophagus utilizing up to 30 nerves and muscles connected to 9 critical cartilages.1
Impaired swallowing or dysphagia may be oropharyngeal involving the oropharynx and laryngopharynx or more inferiorlythe esophagus, in patients with pharyngolaryngeal pain or a globus sensation, usual radiographic evaluations often include videofluoroscopic swallowing studies (VFSS), laryngeal endoscopy, and CT. However, these studies may be ineffective in assessing the hyoid and styloid anatomy, laryngeal endoscopy visualizes the lumen and not the underlying cartilaginous or muscle anatomy, and a static neck CT is ineffective for evaluating dynamic cartilage movements. Accurate interpretation includes awareness of complex oropharyngeal muscular anatomy .2
An analysis of globus oropharyngeal dysphagia may require dynamic cross-sectional imaging studies, ultrasound and it is useful to have a radiographic awareness of critical muscular, neuronal and cartilage anatomy. Ideally, imagers should be aware of key structures affected in muscle weakness, or specific cartilages that dynamically can lead to a “clicking sensation”, during talking, chewing or yawning, associated with severe pain and dysphagia.3-4
The purpose of this website is to present critical muscular, nerve and cartilage anatomy in oropharyngeal dysphagia, oculopharyngeal muscular dystrophy, soft tissue tumors, Eagle’s and superior thyroid cornu syndrome with illustrative anatomy and cross-sectional imaging.
The cross-sectional CT and MRI radiographic examples of oculopharyngeal muscular dystrophy (OMD) with a discussion and review of the intractable myopathy caused by expansion of alanine encoding (GCN)n trinucleotide repeat in the exon 1 of the polyadensoine (poly[A] binding protein nuclear 1 gene is presented, as is the pathophysiology in neuropathologic disorder, Eagle’s and superior thyroid cornu syndrome with a patient’s perspective undergoing treatment for swallowing disorders, and list of resources for patients.
In this website there is illustrative anatomy and corresponding radiographic cross-sectional MRI and CT in normal oropharyngeal swallowing. Specific examples of cross-sectional imaging oculopharyngeal muscular dystrophy, Eagle’s and superior thyroid cornu syndrome are presented. Cross-sectional CT and MRI radiographic examples of oculopharyngeal muscular dystrophy (OMD),are presented. In OMD, a discussion and review of the intractable myopathy caused by expansion of the alanine encoding (GCN)n trinucleotide repeat in the exon 1 of the polyadenosine (poly[A] binding protein nuclear 1 gene is presented, as is the pathophysiology in neuropathologic disorder, Eagle’s and superior thyroid cornu syndrome is presented with a patient’s perspective and experience for treatment of these disorders. Soft tissues with oropharyngeal cancer is also presented. Most importantly, and often lacking in educational research is the patient’s perspective. In this research project, patient’s who are willing to tell their experiences and outcomes from treatment for dysphagia are included as part of this project, allowing clinicians and radiologists the opportunity to realize how important it is to accurately recognize and treat these disorders.
- Matsuo, Koichiro, and Jeffrey B Palmer. “Anatomy and physiology of feeding and swallowing: normal and abnormal.” Physical medicine and rehabilitation clinics of North America vol. 19,4 (2008): 691-707, vii. doi:10.1016/j.pmr.2008.06.001
- Suto A, Ueha R, Ogura T, Maeda E, et al, Yamasoba T. Swallowing computed tomography and virtual reality as novel imaging modalities for the diagnosis of clicking larynx: Two case reports. Auris Nasus Larynx. 2022 Mar 24:S0385-8146(22)00073-6. doi: 10.1016/j.anl.2022.03.018. PMID: 35341625.
- Donner MW, Bosma JF, Robertson DL. Anatomy and physiology of the pharynx. Gastrointest Radiol. 1985;10(3):196-212. PMID: 4029536.
- Wilkinson JM, Codipilly DC, Wilfahrt RP. Dysphagia: Evaluation and Collaborative Management. Am Fam Physician. 2021 Jan 15;103(2):97-106. PMID: 33448766.
- Yamashita S. Recent Progress in Oculopharyngeal Muscular Dystrophy. J Clin Med. 2021 Mar 29;10(7):1375. doi: 10.3390/jcm10071375. PMID: 33805441; PMCID: PMC8036457.