A barium study of hypopharyngeal outpouching

When the hypopharynx is examined in the frontal view during modified Valsalva maneuver after barium swallow anoutpouching of the lateral wall of the hypopharynx resembling a deverticulum is commonly observed. Review of theliterature however fails to disclose provious documentation of systematic prospecative observation of this phenomenon. The present study has been undertaken to detemine the incidence and degree of outpouching according tothe age and sex and to assess the clinical implication of the outpouching. The clinical materials consist of 100 consecutive cases of routine upper GI series with a particular effort directed to induce hypopharyngeal out pouching by a modified Valsalva maneuver at the Department of Radiology, St. Mary's Hospital, Catholic Medical College during 6 months period from Jan. 1982. Technically, outpouching was best demonstrated in the erectposition with a slight extension of the neck during the pharyngeal phase of barium swallowing while the subjectwas instructed to blow through the closed lips. Observation were made ofhhte incidence and intensity of theoutpouching by an arbitrary line drawning to measure the depth of outpouchings. Our study revealed thathypopharyngeal outpouchings occure bilaterally in every case studied. There was definite dominancy on the rightside(p<0.01) and the outpouching was greater in intensity in male (p<0.05) and the depth varied from a few to 15mm. And there was no statistically significant difference according to the age. Outpouchings collapsed and disappeared completely after release of Valsalva maneuver and did not appear to produce any clinical symptoms. The reason of right-side dominancy should further be investigated.