Diagnostic utility of videofluoroscopic swallowing study in patients presenting with the sensation of food sticking in the throat: a retrospective analysis.

Abstract

Background: The sensation of food 'sticking' in the throat is a frequent but diagnostically challenging symptom that often persists despite normal ENT findings. Videofluoroscopic swallowing study (VFSS) enables dynamic evaluation of swallowing physiology and may reveal hidden abnormalities.

Aims/objectives: To assess the diagnostic yield of VFSS in patients with throat-related dysphagia, focusing on abnormality type, localisation, and bolus consistency.

Materials and methods: This retrospective study included 42 patients with persistent symptoms but normal endoscopic examinations between January 2020 and January 2025. Reflux-related findings were excluded. VFSS was performed with nectar-thick liquids, pudding, and solids. Abnormalities were classified by site and etiology. Concordance between symptom site and VFSS findings was analysed.

Results: VFSS detected abnormalities in 74% of patients, predominantly physiological (65%) and within the oesophageal body (55%). Symptom-pathology concordance was low (26%). Solids provided the highest diagnostic yield (50%).

Conclusions and significance: VFSS is valuable in unexplained dysphagia with normal ENT findings, particularly when symptoms occur with solids. Including oesophageal evaluation and varied consistencies improves diagnostic precision and guides management.