Webs and web-like formations in the pharynx and cervical esophagus

Webs were registered in the hypopharynx and cervical esophagus in 63 out of 500 dysphagial patients (12.5%) examined by radiography (single-film and cineradiography). Of these webs three were located above the level of the cricopharyngeal muscle. All the webs had smooth contours, were distinct and appeared unchanged on repeated swallowings. They were located mostly in the anterior wall, but could be circular. Such webs were found in only 2 of the 150 volunteers (1.3%). Therefore, it is reasonable to assume that these webs may give rise to dysphagia. Another form of mucosal folding on swallowing was registered in the lateral wall of the pharynx at the distal margin of the piriform sinuses in 16 of the 500 dysphagial patients (3.2%) and in 9 of the 150 nondysphagial volunteers (6%). This web-like phenomenon could be reproduced and identified in 5 freshly obtained autopsy specimens in which a mucosal fold was regularly formed on distention at the distal margin of the piriform sinuses due to loosely attached mucosa. This mucosal folding does not seem to have any pathologic significance nor does it cause dysphagia. With the aid of cineradiography it is possible to distinguish true webs from other web-like phenomena that are due to the described insignificant mucosal foldings.