Radiology Forums

Lucille · Guest

I would like to know if anyone has had experience with the use of a barium-containing nasal spray used in fluoroscopy to evaluate the upper airway. Could this be used to image
glossoptosis of the tongue base and other changes which occur with inspiration and expiration in a patient with an airway obstruction caused by changes in the hypopharangeal space due to involuntary contraction of facial and platysma muscle which retracts the jaw?

Nasoendoscopic exam revealed a retrodisplacement of the tongue base and retroflexion of the epiglottis with the head in a normal position, causing a narrowing of the airway. However, with the neck flexed and head rotated, the patient is able to keep the tongue base from obstructing the airway. Modified Barium Swallow revealed a pharyngeal phase dysphagia. When the patient is asked to protrude the tongue and move the neck and head from a neutral to an extended position, the tongue retracts abnormally.

Any suggestions regarding the use of fluoroscopy to capture dynamic changes with head/neck in neutral and extended positions to determine exactly when the tongue base moves into the problematic position during inspiration would be helpful.

Thank you.

Gator · Guest

I've never heard of nasal spray barium but the concept sounds cool. I hope someone else knows more.
Gator