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Index
a
Aberrant right subclavian arteries (ARSA). See
Arteria lusoria
Achalasia, 47, 51, 54, 85, 97, 101, 102, 104–106, 171, 177,
192, 193
bird-beak sign, 153, 155
cricopharyngeal achalasia, 165
FBF scoring system, 140–141
late-stage achalasia, 156
type I achalasia, 153, 154
type II achalasia, 153, 154
type III achalasia, 153, 155
Acquired bronchoesophageal stulae, 88, 89
Acquired tracheal stulae, 88, 89
Acrosclerosis, 158
Actinomycosis, 182
Acute adenoiditis, 150–151
Acute esophagitis, 107
Acute pharyngitis, 150
Acute tonsillitis, 150
Adenocarcinoma, 173, 174
Aging esophagus, 47
Aneurysms, 30, 82, 84, 85, 87
Aortitis, 82, 85, 87
Arch-derived cartilage, 1
Arteria lusoria, 85–87
CT imaging of, 192
MRI reconstruction of, 194, 195
Arteriosclerosis, 85
Aspiration, 39, 46, 47, 51, 52, 114 –115, 120, 121–124,
127,129–132, 139, 146, 149, 165, 186
Atelectasis, 88
Atresia, 107
Auditory tube, 2
Avellis syndrome, 148
B
Bacterial esophagitis, 176
Barium sulfate (BaSO4) contrast media
applications, 10 9
chemical formula, 109
description, 109
for GI imaging
barium aspiration, 114 –115
barium embolization, 115
barium obstruction and impaction, 114
complications, 113
computed tomography, 113
modied barium swallow study (MBSS)/
videouoroscopic swallow study (VFSS),
112–113
perforation of upper GI tract/small bowel,
113–114
single-contrast examination, 112
through radiographic imaging, 111–112
laxatives, 111
moisturizers, 111
mucosal coating, 111
non-coating thickeners, 111
pH regulators, 111
properties, 109, 110
in radiographic procedures, 110
suspension of particles, 110–111
sweeteners, 111
Barium swallow examination
uoroscopy, 93
image intensier chain
collimator, 94
at-panel uoroscopes, 97–98
uoroscopy vs. radiography, 98
generator, 93
image intensier, 94
output phosphor image displays, 94, 95
radiographic image displays, 96–97
X-ray tube, 94
Barrett’s esophagus, 47
Barrett’s ulcer, 159, 184–185
Benign and malignant esophageal tumors
adenocarcinoma, 173, 174
benign esophageal tumors, 172
esophageal leiomyoma, 172
esophageal melanoma, 174, 175
granular cell tumor, 174
malignant esophageal tumors, 173
neurobromas, 172, 173
papillomas, 172
squamous cell carcinoma, 173
Benign esophageal tumors, 172
Benign nodular struma, 81–82
Benign strictures, esophageal disorders
Barrett’s ulcer, 159
cricopharyngeal (CP) bar, 163, 165 –166
double ring, 163
reux esophagitis, 159
ring-like strictures, 160
Schatski’s ring, 162–164
webs, 160 –163
Blastomycosis, 182
Boerhaave’s syndrome, 91
Botulism, 149
Brain tumors, 148
Branchial arches, 1, 2
Branchial/visceral arches, 3, 4
hyoid arch, 3
mandibular arch, 3
Meckel’s cartilages, 5
sinus cervicalis, 5
Buccinator, 10, 11, 16, 33, 34, 38
Bulbar palsy, 146–148
C
Candidiasis, 176–177
Captured bolus test, 106
Cardiomegalia, 84, 85
Catarrhal acute esophagitis, 176
Cerebral/intermediate lesions, 146
199
Index
Cervicothoracic scoliosis, 82
Chagas disease, 177, 178
Chronic pharyngitis with ulcers, 151
Cleft palate, 8
Collagen disorders, esophageal disorders
acrosclerosis, 158
dermatomyositis (polymyositis), 158–159
lupus erythematous, 159
rheumatoid arthritis, 159
scleroderma, 157–158
Cranial base bones, 1
Cricopharyngeal achalasia, 165
Crohn’s disease, 182, 192, 194
Curling ulcers, 150
Cushing ulcers, 150
d
Deglutition. See Swallowing
Dermatomyositis (polymyositis), 158–159
Diffuse esophageal spasm, 153, 156, 157
Diphtheritis, 148–149
Diverticula
acquired, 166
congenital, 166
epiphrenic diverticula, 171–172
Killian–Jamieson diverticulum, 166–168
laryngoceles, 169
lateral pharyngeal pouches, 169
of thoracic esophagus, 169 –171
Zenker’s diverticula, 29, 42, 51, 52, 57, 165–168
Dynamic barium swallow protocol, 101–103
Dysphagia, 29, 37, 45, 50, 51, 54, 81, 82, 85, 101, 105, 118,
144, 146, 14 8, 151, 159, 160, 162, 165, 181–183
dynamic barium swallow, 101
dysphagia aortica, 30
dysphagia lusoria, 30
esophageal dysphagia, 33, 51
oropharyngeal dysphagia, 33
pharyngoesophageal endoscopy of, 57
solid food dysphagia, 51
symptoms of, 27
e
Edema, 174
Elevator esophagus, 156
Emphysema, 88
Endochondral bones, 1
Endochondral ossication, 1
Eosinophilic esophagitis, 175
Epidermolysis bullosa, 181
Epiphrenic diverticula, 171–172
Esophageal atresia, 185 –186
Esophageal clearance, 137
Esophageal dysmotility, 47
Esophageal leiomyoma, 172
Esophageal melanoma, 174 , 175
Esophageal neurobroma, 191, 192
Esophageal webs, 160–163
Esophagitis
acute esophagitis, 174
candidiasis, 176–177
catarrhal acute esophagitis, 176
caustic and chemical esophagitis
acid agents, 178–179
alcohol and tobacco use, 179
alkali substances, 178
caustic substances, 178
dust and fumes, 179
heat esophagitis, 181
peptic esophagitis, 180–181
Chagas disease, 177, 178
chronic bacterial esophagitis, 176
edema, 174
eosinophilic esophagitis, 175
renal transplant, 176
schistosomiasis, 177–178
thrush, 176
ulcerative esophagitis, 176
Esophagus. See also Specic entries
Auerbach’s plexus, 28
benign and malignant esophageal tumors
adenocarcinoma, 173, 174
benign esophageal tumors, 172
esophageal leiomyoma, 172
esophageal melanoma, 174, 175
granular cell tumor, 174
malignant esophageal tumors, 173
neurobromas, 172, 173
papillomas, 172
squamous cell carcinoma, 173
benign strictures
Barrett’s ulcer, 159
cricopharyngeal (CP) bar, 163, 165 –166
double ring, 163
reux esophagitis, 159
ring-like strictures, 160
Schatski’s ring, 162–164
webs, 160 –163
cervical esophagus, 29
clasp and sling bers of gastroesophageal
junction, 30
collagen disorders
acrosclerosis, 158
dermatomyositis (polymyositis), 158–159
lupus erythematous, 159
rheumatoid arthritis, 159
scleroderma, 157–158
computed tomography (CT) imaging, 191–196
Curling ulcers, 150
Cushing ulcers, 150
deciency disorders
sideropenic anemia, 182–183
vitamin deciency, 183
detailed structure of, 27–28
diverticula
acquired, 166
congenital, 166
epiphrenic diverticula, 171–172
Killian–Jamieson diverticulum, 166–168
laryngoceles, 169
lateral pharyngeal pouches, 169
of thoracic esophagus, 169 –171
Zenker’s diverticula, 166 –168
200
Index
downhill varices, 29
erosions, 91
esophageal atresia, 185–186
esophagitis
acute esophagitis, 174
candidiasis, 176–177
catarrhal acute esophagitis, 176
caustic and chemical esophagitis, 178–181
Chagas disease, 177, 178
chronic bacterial esophagitis, 176
edema, 174
eosinophilic esophagitis, 175
renal transplant, 176
schistosomiasis, 177–178
thrush, 176
ulcerative esophagitis, 176
granulomatous lesions, 181–182
histology of esophageal wall, 27, 29
incisions, 90–91
ingested foreign bodies, 186 –188
Killian–Jamieson diverticula, 29
magnetic resonance imaging (MRI), 192, 194 –196
Mallory–Weiss syndrome, 91
Meissner’s plexus, 28
motility disorders
diffuse esophageal spasm, 153, 156, 157
elevator esophagus, 156
primary achalasia, 153 –156
secondary contractions, 152
tertiary contractions, 152–153
and orohypopharynx, 79–80
radiographic anatomy (see Radiographic anatomy)
ruptures, 91
skin disorders
epidermolysis bullosa, 181
herpes simplex, 181
pemphigus vulgaris, 181
thoracic esophagus, 29
topographic anatomy, 59–60
ulcers of
Barrett’s ulcer, 184–185
iatrogenic ulcers, 185
kissing ulcers, 185
marginal ulcers, 185
peptic ulcerations, 184
Eustachian tube, 2
E-Z-EM, Inc., 101
f
Fiberoptic endoscopic evaluation of swallowing
(FEES), 52, 56, 57
Fiberoptic nasolaryngoscopy/video nasoendoscopy,
55
Fibrosclerosis, 90
Fibrovascular polyp, 192, 193
Forestier disease, 82, 83
Frontonasal process, 1
g
Gastroesophageal reux disease (GERD), 47, 51, 53,
106, 107, 165, 179
Gill clefts, 3
Gingivae/gums, 11
Globus hystericus, 51
Globus sensation, 51
Granular cell tumor, 174
Granulomatous lesions, esophageal disorders
actinomycosis, 182
blastomycosis, 182
Crohn’s disease, 182
histoplasmosis, 182
sarcoidosis, 182
syphilis, 182
tuberculosis (TB), 181–182
h
Heat esophagitis, 181
Herpes simplex, 181
Hiatal hernia, 106–107, 159, 160, 192, 194
High-osmolality iodinated contrast media (HOCM)
aspiration, 115–116
complications, 115
hypovolemia, 116
osmol a l it y, 115
precipitation, 116
Histoplasmosis, 182
HOCM. See High-osmolality iodinated
contrast media
Hydropneumothorax, 91
Hypovolem ia, 116
I
Iatrogenic ulcers, 185
Inammatory lesions, pharyngeal disorders
acute adenoiditis, 150–151
acute pharyngitis, 150
acute tonsillitis, 150
chronic pharyngitis with ulcers, 151
K
Killian–Jamieson diverticulum, 29, 166 –168
Killian zone, 42
Kissing ulcers, 185
Kyphoscoliosis, 83
l
Laryngeal vestibular closure, 130
Laryngoceles, 169
Larynx
appendix, 26
arcus cartilaginis cricoideae, 24
arytenoid cartilages, 24, 25, 27
cartilagines laryngis, 23
colliculus, 24
corniculate cartilage, 25
cricoid cartilage, 23, 24
crista arcuata, 24
cuneiform cartilages, 25
epiglottis/cartilago epiglottica, 23, 25
glottis respiratoria, 27
201
Index
glottis vocalis, 27
interarytenoid notch, 25
laryngeal prominence, 23
laryn x cavity/cavum laryngis, 25
rima glottidis, 26, 27
superior and inferior cornua, 23, 24
superior thyroid notch, 23
thyroid cartilage, 23, 24
ventriculus laryngis (Morgagni)/laryngeal sinus,
26
vocal folds, 25, 27
Lateral amytrophic sclerosis, 148
Lateral pharyngeal pouches, 169
Lip closure, 120
Lupus erythematous, 159
m
Malignant esophageal tumors, 173
Mallory–Weiss syndrome, 91
Mandibular segment, 1
Marginal ulcers, 185
Mastication muscles
masseter muscle, 18
pterygoideus externus, 18, 19
pterygoideus internus, 18–20
temporalis, 18, 19
Maxillary segment, 1
M B SI mP. See Modied barium swallow impairment
prole
Meckel’s cartilages, 5
Mediastinal adenopathy, 88–89
Mediastinitis, 81, 89–90, 110, 114
Modied barium swallow impairment prole
(MBSImP)
esophageal analysis, 140
objectives, 118
patient preparation and positioning, 119
Penetration-Aspiration Scale (PAS), 138–140
physiological components
anterior hyoid excursion, 128
bolus preparation/mastication, 122
bolus transport/lingual motion, 122, 123
epiglottic movement, 129
esophageal clearance, 137
laryngeal elevation, 127
laryngeal vestibular closure, 130
lip closure, 120
oral residue, 123, 124
pharyngeal contraction, 132
pharyngeal residue, 136
pharyngeal stripping wave, 131
pharyngeal swallow, initiation of, 124, 125
pharyngoesophageal segment opening, 133
soft palate elevation, 126
tongue base retraction, 134–135
tongue control during bolus hold, 121
protocol overview
esophageal phase, 119
oral phase, 118
pharyngeal phase, 119
scoring and interpretation, 138
standardized bolus administration, 119
Modied barium swallow study (MBSS), 112–113, 118
Morphodynamical imaging
acid barium, 106
for acute esophagitis, 107
for atresia, 107
captured bolus test, 106
for children and newborns consuming alien
objects, 107
classic barium swallow, 105
double-contrast esophagrams, 100
double-lumen tube-balloon test, 106
dynamic barium swallow protocol, 101–103
for gastroesophageal reux, 107
for hiatal hernia, 106 –107
mecholyl, 106
single-contrast technique, 100
special maneuvers and positions
Johnston’s bending-over position, 105
Müller technique, 105
Trendelenburg position, 105
Valsalva maneuver, 105
Wolf’s position, 105
timed barium esophagogram (TBE), 103–105
water siphonage test, 106
for webs, 107
Motility disorders, esophageal disorders
diffuse esophageal spasm, 153, 156, 157
elevator esophagus, 156
primary achalasia, 153 –156
secondary contractions, 152
tertiary contractions, 152–153
Mucosal webs, 45
Multiple sclerosis, 148
Muscular disorders, pharyngeal disorders
muscular dystrophy, 150
myasthenia gravis, 149–150
stiff man’s syndrome, 150
Muscular dystrophy, 150
Myasthenia gravis, 149–150
n
Neural crest cells, 1
Neurobromas, 172, 173
Neurogenic neoplasms, 89
Neuromuscular disorders, pharyngeal disorders
Avellis syndrome, 148
brain tumors, 148
bulbar palsy, 146–148
cerebral/intermediate lesions, 146
lateral amytrophic sclerosis, 148
multiple sclerosis, 148
peripheral lesions, 148
pseudobulbar palsy, 146 –148
reex-arc lesions, 14 4 –146
o
Odynophagia, 52
Oral cavity
branchial origin of, 3–8
cavum oris proprium, 8
fauces, 14
202
Index
formation, 1
frenulum, 9
gingivae/gums, 11
glanduloe labiales, 10
hard palate, 11, 12
isthmus faucium, 9
labia oris, 9
mastication muscles, 18 –20
median raphe, 12
molar glands, 11
mucous membrane, 9–12
oral cavity proper, 8
palate muscles, 14–16
palatine uvula, 12
palatine velum, 12
pharynx and cheek muscles, 16, 17
schematic representation of, 8, 10
soft palate, 11
tongue, 12–14
vestibule, 8
Orohy popharynx, 79–80
Oropharyngeal dysphagia, 33
P
Palate muscles
glossopalatinus/palatoglossus, 14–16
levator veli palatini, 14, 15
musculus uvulae/azygos uvulae, 14 –16
pharyngopalatinus/palatopharyngeus, 14, 16
tensor veli palatini, 14, 15
Papillomas, 172
Parathyroid tumors, 82
Parkinsonism, 146
Paterson–Brown–Kelly syndrome, 182
Pemphigus vulgaris, 181
Penetration-Aspiration Scale (PAS), 138–140
vs. modied barium swallow impairment prole
(MBSIm P), 140
Peptic esophagitis, 180 –181
Peptic ulcerations, 184
Pericardial effusion, 84
Peripheral lesions, 148
Permanent nasal apertures, 8
Pharyngeal pouches, 3, 5
columella, 6
fossa of Rosenmüller, 5
frontonasal process, 6, 7
nasal laminae, 6
naso-optic furrow, 6
olfactory pits, 6, 8
sinus tonsillaris, 5
thymus gland, 6
Pharyngoesophageal disorders
multidisciplinary assessment of, 52–53
patient’s history, 50
radiologic assessment, 50
symptoms
aspiration, 51
chronic cough, 52
dysphagia, 51
globus sensation, 51
odynophagia, 52
regurgitation, 52
weight loss, 52
Pharyngoesophageal endoscopy
clinical indications, 55–56
in dysphagia management, 57
of esophageal lumen in esophagitis patient, 54
beroptic nasolaryngoscopy/video
nasoendoscopy, 55
of gastroesophageal junction in achalasia
patient, 54
vs. M B SI mP, 56
modied barium swallow impairment prole
(MBSIm P), 55
overview of, 54, 55
procedural technique, 56
risks and considerations, 57
transnasal esophagoscope (TNE), 55, 56
vs. VFSS, 56
videouoroscopic swallow study (VFSS), 55
Pharyngoesophageal mucosal prole, external and
internal affecting factors
acquired bronchoesophageal stulae, 88, 89
acquired tracheal stulae, 88, 89
aneurysms, 85, 87
aortic arch, 84–85
aortitis, 87
arteria lusoria, 85–87
atelectasis, 88
benign nodular struma, 81–82
both atria, 84
cardiomegalia, 84, 85
cervicothoracic scoliosis, 82
emphysema, 88
brosclerosis, 90
Forestier disease, 82, 83
left atrium, 83–84
left ventricle, 84
malignant neoplasm of thyroid, 82
mediastinal adenopathy, 88–89
mediastinitis, 89–90
neurogenic neoplasms, 89
parathyroid tumors, 82
pericardial effusion, 84
pleural adhesions, 87–88
pleural effusion, 87
pneumothorax, 88
retropharyngeal abscess, 81
right atrium, 84
spondylosis deformans, 82
thoracic aorta, 84–85
thoracic spine, 82–83
thyroid gland enlargement, 81
thyrotoxicosis, 81
trauma, 90
Pharyngoesophageal segment (PES), 44, 45, 47, 131,
133–134
Pharynx. See also Specic entries
branchial origin of, 3–8
and cheek muscles, 16, 17
computed tomography (CT) imaging, 191–196
detailed structure of, 20
inammatory lesions
acute adenoiditis, 150–151
203
Index
acute pharyngitis, 150
acute tonsillitis, 150
chronic pharyngitis with ulcers, 151
magnetic resonance imaging (MRI), 192, 194 –196
muscles
inferior constrictor, 21
middle constrictor, 21, 22
pharyngopalatinus, 21, 22
salpingopharyngeus, 21, 22
stylopharyngeus, 21, 22
superior constrictor, 21, 22, 38, 41, 79
muscular disorders
muscular dystrophy, 150
myasthenia gravis, 149–150
stiff man’s syndrome, 150
neuromuscular disorders
Avellis syndrome, 148
brain tumors, 148
bulbar palsy, 146–148
cerebral/intermediate lesions, 146
lateral amytrophic sclerosis, 148
multiple sclerosis, 148
peripheral lesions, 148
pseudobulbar palsy, 146 –148
reex-arc lesions, 14 4 –146
radiographic anatomy See Radiographic anatomy
segments
pars laryngea pharyngis, 21
pars nasalis pharyngis/nasopharynx, 20–21
pars oralis pharyngis, 21
topographic anatomy, 59–60
toxic myopathies
botulism, 149
diphtheritis, 148–149
rabies, 149
Pleural adhesions, 87–88
Pleural effusion, 87
Plummer–Vinson syndrome, 182
Pneumothorax, 88
Pouc hes. See Clefts
Presbyesophagus, 47
Preventative apnea. See Swallowing apnea
Primary achalasia, 153–156
Pseudobulbar palsy, 146–148
r
Rabies, 149
Radiographic anatomy
of bolus in mouth, 60
of bolus on tongue, 60, 61
of cervical esophagus, 72, 73
of esophageal hiatus, 77
of gastroesophageal junction, 78, 79
of hypopharynx
anteroposterior projection, 68, 69
cricopharyngeal impression, 65, 67
lateral position, 65
pharyngoesophageal junction, 68
residue at pharyngoesophageal junction, 68, 69
Valsalva maneuver, anteroposterior projection,
68, 70
of incisura and stomach cardia, 78, 79
of lower esophageal sphincter zone, 76–78
of nasal cavity, 62, 65
of neck stripes and esophagus, 78–79
of oral cavity
anteroposterior projection, 62, 63
barium column through oropharynx, 62, 64
barium lls mouth lateral recesses, 62, 63
palate roof, 61, 62
residual barium after swallow, 62, 64
of oropharynx
barium residue on valleculae, 65, 66
barium through hypopharynx, 65, 67
epiglottis, 65, 66
of pharyngoesophageal junction, 70
of pharyngoesophageal sphincter, 70–72
of thoracic esophagus
aortic portion, 73–75
aorto-bronchial portion, 75
bronchial portion, 75, 76
epiphrenic portion, 76, 77
paratracheal portion, 73, 74
retrocardiac portion, 76
topographic anatomy of, 73
Reex-arc lesions, 144 –146
Reux esophagitis, 159
Regurgitation, 29, 51, 52, 62, 101, 103, 107, 114, 115, 126,
144, 146, 14 8, 150, 162
Retropharyngeal abscess, 81
Rheumatoid arthritis, 159
s
Sarcoidosis, 182
Schatski’s ring, 162–164
Schistosomiasis, 177–178
Scleroderma, 157–158
Sideropenic anemia, 182–183
Skin disorders
epidermolysis bullosa, 181
herpes simplex, 181
pemphigus vulgaris, 181
Spondylosis deformans, 82
Squamous cell carcinoma, 173, 191
Stiff man’s syndrome, 150
Superior constrictor, 21, 22, 38, 41, 79
Swallowing, 50
aging esophagus, 47
conduction, 33
beroptic endoscopic evaluation of swallowing
(FEES), 52
uoroscopic evaluation of
oral phase, 43–44
pharyngeal swallowing phase, 44–45
in geriatric patients
oral phase, 46
pharyngeal phase, 46–47
muscle contraction, 33
neural control of
base nuclei, 36–37
cerebellum, 36–37
cerebral cortex, 36–37
chewing muscles, 32–34
cortex-pons-cerebellar pathway, 37
204
Index
cranial nerves, 35–36
and esophageal phase, 42–43
oral gulps phase, 39
oral qualication, 34–35
oral spontaneous phase, 39–40
and pharyngeal phase, 32, 33, 40–42
primary voluntary oral cortical phase, 39
semiautomatic oral phase, 39
voluntary oral phase, 37–39
overview of, 32
in pediatric and infant patients, 47
pharyngoesophageal segment (PES), 47
physiologic swallowing, 45
“swallowing reex” event, 33
Swallowing apnea, 39
Syphilis, 85, 182
t
Thyroid gland, 22
enlargement, 81
Thyrotoxicosis, 81
Timed barium esophagogram (TBE), 103–105
Tongue base retraction, 134 –135
Tongue musculature, 2
Topographic anatomy
esophagus, 59–60
pharynx, 59–60
Toxic myopathies, pharyngeal disorders
botulism, 149
diphtheritis, 148–149
rabies, 149
Transnasal esophagoscope (TNE), 55, 56
Tuberculosis (TB), 181–182
u
Ulcers of esophagus, 176
Barrett’s ulcer, 184–185
iatrogenic ulcers, 185
kissing ulcers, 185
marginal ulcers, 185
peptic ulcerations, 184
Upper esophageal sphincter (UES).
See Pharyngoesophageal segment (PES)
v
Videouoroscopic swallow study (VFSS),
112–113, 118
Vocal organ. See Larynx
w
Water siphonage test, 106
Z
Zenker’s diverticulum, 29, 42, 51, 52, 57,
165 –168
205
