Dysphagia localized to the hypopharynx and upper esophagus may result from various local and systemic diseases. Currently available cineradiographic and manometric techniques permit the delineation of the normal mechanism of swallowing and the deviations from normal in various disease states.
Normally, relaxation of the cricopharyngeus (upper esophageal sphincter) precedes hypopharyngeal peristaltic contraction. In 2 patients with dysphagia in association with the posterior inferior cerebellar artery syndrome, relaxation of the cricopharyngeus was delayed, thus leading to pharyngeal contraction against an unrelaxed sphincter.
In diseases involving striated muscle, including myotonia dystropica (12 patients), sarcoid (2 patients), and derma tomyositis (4 patients), abnormalities