Preliminary Information

• The hypopharynx and cervical esophagus are to be included in the esophageal study if disease is suspected in this region or if the patient refers symptoms to the throat or neck.
  
  
• Perform the study with the patient upright (or as nearly upright as possible).
  
  
• Use "thick barium" (high-density, high-viscosity).
  
  
• Record swallowing dynamics in both lateral and AP projections with a digital camera set at 4 frames per second. Use 9" or 12" image intensifier (II) field of view (FOV). Cone-in side-to-side.
  
  
• Record anatomy of hypopharynx in AP and lateral projections while patient is phonating.
  
  
• Explain the procedure to patient. You will count "one, two, three" out loud. For each swallow, you will have the patient swallow barium on the count of 'three", but you will begin rapid sequence (4/sec) recording with the camera on the count of "two".