Studies of Esophageal Webs by 35mm-Cinefluorography

The clinical significance of cervical esophageal webs has yet to be established. Detailed examination of the pharyngoesophageal junction during the rapid passage of the barium bolus is essential for the diagnosis of the web. One hundred and ninety-one outpatients with globus symptoms were cinefluorographically examined by utilizing a 35mm cine camera incorporated in the fluoroscopy unit with a 9-inch image intensifier. Frontal and lateral views were obtained during the barium swallowing in the sitting position with the camera speed of 48 frames per second. The Tagarno projector was used for the study of cine films.The classical cervical esophageal webs were demonstrated in 33 cases (17.3%) as thin indentations at the anterior wall of the cervical esophagus just below the cricoid cartilage. The webs varied in depth; 1mm in 7 cases, 2mm in 13, 3mm in 7, 4mm in 3, 5mm in one, 7mm in one, 8mm in one, and 10mm in one. The webs were demonstrated also in various durations; 10 cases in less than 6 frames (0.125 seconds), 8 in 6 to 12 frames (0.25 seconds), 13 in 12 to 24 frames (0.5 seconds), and 2 in more than 24 frames. The depth of the indentation was apparently not correlated with the number of frames of the detectable webs.Web-like indentations were seen in the distal margin of the pyriform sinus and in the post-cricoid region of the hypopharynx as well, in 31 (16.2%) and 4 (2%), respectively.It is most likely that the incidence of cervical esophageal webs increases with the use of high-resolution and high-speed cinefluorography.