Esophageal manometry should be done first,

Thanks 

Dear Dr, Chandramouli, I suggest to Investigate effect of neuro-anatomy lesion of post-operatory iatrogenia of Recurente, Thyro-glosso-pharyngeal, vagal nerves & Plexo braquial complex in swallowing mechanism.

Thanks, do you suggest an ENMG of 9,10,11,12 ? if so how do you do it ?

Ba swallow shows delay, no mechanical obstruction. endoscopy = no intraluminal obstruction or stricture but DYSMOTILITY. 

MRI normal.

1. this article is comprehensive for sensory physiology of esophagus>>http://www.nature.com/gimo/contents/pt1/full/gimo16.html

2. many PubMed articles focus on continuous intra-op monitoring of vagus nerve mainly for minimally invasive thyroid surgeries and esophagectomy surgeries.

3. wiki says ENS - ENTERIC NERVOUS SYSTEM is the 'brain of the gut' >so another natural question to follow would be > how to do a 'metabolic scan' of the esophagus motility- ( similar to MEG of the brain or a PET-CT scan for cancer and nodes ) 

4. the ENMG mentioned above has to non-invasive, also the M bit of the ENMG i.e., the myenteric and submucosal plexuses of the ENS are indeed very complex !

**Re-instate!  manometry is practical and next best as of now**