Does recurrentor severe aspiration imply underlying oropharyngeal dysfunction despite a reassuring SLP/VFSS evaluation?

GI is often consulted when esophageal dysmotility, poor clearance, or reflux is identified on video-fluoroscopic swallowing evaluation. While these may contribute to aspiration, many patients with significant esophageal obstruction do not aspirate. Can esophageal dysfunction alone account for recurrent aspiration with otherwise intact airway protection, or should occult/intermittent oropharyngeal dysfunction remain a concern?