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A brief outline of the causes and symptoms of hypopharyngeal paresis is followed by a discussion of the diagnostic possibilities of manometry and cineradiography. It was found that the pharyngoesophageal sphincter mechanism remains intact in the case of complete paralysis of the hypopharynx. When there are severe symptoms of dysphagia, myotomy of the pharyngoesophageal sphincter is to be considered on the basis of these diagnostic findings. This procedure can lead to substantial improvement of the symptoms. Sphincterotomy yielded very favorable results in five out of nine patients, two of whom are discussed in some detail by way of illustration.