Gulp

Question: A 67 year old female presents to your clinic with the chief complaint of difficulty swallowing. She has seen 3 gastroenterologists and 2 otolaryngologists without improvement. A modified barium swallow was normal. Upon focused review of systems she also notes voice raspiness at the end of the day, chronic cough, and a history of reflux. Flexible nasolaryngoscopy and FEES are normal. Which of the following is the most likely diagnosis?

a) Cricopharyngeal spasm

b) Laimer’s diverticulum

c) Paradoxical vocal fold motion

d) Muscle tension dysphagia

[Answer will be posted with next week's new question]

Answer to last week's question, “Magnets: Big and Small” (February 20, 2022)

D - DWI.