Video-fluoroscopy in a graduated diagnostic program in oral cavity and pharyngeal carcinoma

The role of videofluoroscopy in the preoperative evaluation of 38 carcinomas of the oral cavity and oro-/hypopharynx is described. The analysis compared videofluoroscopy with CT and endoscopic assessment, since videofluoroscopy is the only imaging method that can record dynamic motility changes during deglutition. The intraluminal part of the tumour is well visualised by high contrast resolution of the pharyngeal mucosa. The extent of tumorous infiltration can be evaluated via indirect criteria such as leaking, vallecular asymmetry, impaired epiglottic movement with insufficient vestibular closure, pharyngeal wall rigidity, and laryngeal aspiration. Carcinoma of the oral cavity and piriform sinus often do not cause functional swallowing impairments that can be detected by videofluoroscopy. However, in case of carcinoma at the base of the tongue region as the major driving force in bolus movement, videofluoroscopic assessment yields important additional information supplementing CT and endoscopic findings.