Objectives/Hypothesis: The region posterior to the cricoid cartilage is challenging to assess fluoroscopically. The purpose of this investigation is to critically evaluate the posterior cricoid (PC) region on fluoroscopy and describe patterns of common abnormalities. Study Design: Retrospective chart review. Methods: A fluoroscopic database was queried for studies documenting PC abnormalities. All studies identified were selected, reviewed and re-evaluated. Patient demographics, referral diagnoses, symptoms, and past medical history were abstracted. The studies were analyzed and categorized into distinct patterns of findings. Results: Forty-eight PC irregularities were identified from the database. Four patients had incomplete study data and were excluded. The indication for the swallow study was dysphagia (14%), globus and GERD (30.2%), head and neck cancer (25.5%), neurologic disease (9.3%), vocal fold paralysis (7%), Zenker's diverticulum or cricopharyngeal bar (7%) and spinal surgery (7%). Three distinct groups were identified. 20/44 patients demonstrated distinct immobile webs centered on C5. 25/44 demonstrated a mobile fluoroscopic irregularity that moved between C4 and C5. We call this the posterior cricoid jag. 2/44 demonstrated an immobile anterior indentation in the barium stream that is consistent with outlining of the posterior cricoid arch. We call this the posterior cricoid impression. Three patients had both a web and a posterior cricoid jag. Conclusions: Posterior cricoid findings on fluoroscopy can be classified into esophageal webs (45%), posterior cricoid impressions (4.5%), and posterior cricoid jags (56.8%).
ASJC Scopus subject areas