Videofluoroscopia

Videofluoroscopia is a radiographic procedure that uses real-time X-ray imaging to visualize movement of a contrast agent through the mouth, pharynx, esophagus, and related structures. It is commonly performed to assess swallowing function and esophageal transit, most often as a videofluoroscopic swallow study (VFSS). The examination is typically conducted by a radiologist with collaboration from a speech-language pathologist and may be referred to as cinefluorography or dynamic swallow assessment.

During the study, the patient ingests standardized volumes and consistencies of radiopaque contrast (such as barium) while the fluoroscopy unit records the motion. The resulting video allows frame-by-frame review of bolus formation, transit, airway protection, residue, penetration, and aspiration, as well as detection of structural or functional abnormalities in the oropharynx and esophagus. The test can be adapted to evaluate different textures, volumes, and timing to simulate normal eating conditions as much as possible.

Indications include suspected swallowing disorders (dysphagia), risk of aspiration, evaluation of esophageal motility, preoperative planning, and assessment after stroke or head and neck cancer treatment. Safety considerations focus on radiation exposure and contrast reactions; measures are taken to minimize dose (ALARA), and the test is generally avoided in pregnant patients unless benefits clearly outweigh risks. Preparation typically involves fasting and avoiding metals or jewelry that interfere with imaging, and patients are positioned to optimize visualization of swallowing mechanics.

Results guide clinical decisions on diet modification, compensatory strategies, and swallowing therapy, and may prompt additional investigations such as endoscopy or esophageal manometry when needed.