of the hypopharynx appears smooth and straight. The closed laryngeal introitus causes irregular­ity in the upper section of the hypopharynx’s anterior wall. The impression of the cricoid lamina and the superimposed shadows of the pyriform fossae or lateral channels also generate irregular­ity in the lower part of the anterior wall. Because of the thickened, redundant mucosa and the engorged venous channels that are frequently present routinely in this location, the impression of the cricoid lamina may seem as an uneven anterior mucosal defect or even mimic a tumor. A tiny irregular incisura or notch at the pharyngoesophageal junction can be seen at the level of the lower pole of the cricoid lamina (Figure 5.14). The posterior cricopharyngeal impression can range from a prominent semilunar indentation to a small anterior bend in the posterior column. The lower or postcricoid part of the hypopharynx is seen as a linear channel coated by the retained barium in the compressed mucosal folds in the lateral view that is taken soon after the barium bolus is consumed with the mouth closed. At the pharyngoesophageal junction, a tiny quantity of retained barium at the lower end of this channel above the typically closed sphincter may resemble a pseudodiverticu­lum (Figure 5.15). Barium in the hypopharyngeal region opacies the valleculae, which show up as two opaque pockets on anteroposterior views (Fig u r e 5.16). Because of the “folded over” epiglottis, opacication is not complete below this point. Normal hypopharyngeal bulges, sometimes called “ears,” can be seen laterally in the frontal plane views. These “ears” are the result of the thyrohyoid ligaments stretching into the pyriform fossae, which in turn lead into the postcricoid lamina and the last segment of the funnel-shaped segment of the hypopharynx. The region of the pyriform sinuses may occasionally exhibit normal lateral notchings. Due to rotation and the potential asym­metry brought on by uneven barium retention, these notches can be misinterpreted for webs if only one side is visible. Two symmetrical pockets at the base of the tongue are typically the clearest de­nition of the valleculae (Fig ure5.16). The inverted epiglottis may have a star-like appearance when a swallow is at its tallest. If the typical epiglottis is covered with leftover barium when at repose, it may occasionally be delineated (Figure 5.10). The lateral “ears” mentioned previously are empha­sized by the lateral air-lled bulges created in the upper lateral channel by lms exposed during the Valsalva maneuver (Fig ure 5.17).

subject’s age affect the degree of indentation. The indentation is slight and unnoticeable in new­borns and youngsters whose aorta is underdeveloped. Notching may be observed at the site of compression due to wrinkling of the mucosal pattern in the elderly, especially in the presence of atheromatous alterations. It is recommended to take typical PA frontal, right oblique, left oblique, and lateral views in order to analyze this area and rule out a vascular ring or aberrant arteries.