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    Anatomy of Hypopharynx

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    Vasant Chaudhari
    The hypopharynx or laryngopharynx is the lower part of the pharynx behind the larynx. It has anterior and posterior walls, and lateral walls with depressions called pyriform fossae. The pyriform fossae are sites where foreign bodies and tumors commonly lodge. The hypopharynx is supplied by nerves, blood vessels, and lymphatics and is involved in swallowing and speech. Tumors commonly occur in the pyriform fossae or postcricoid region and often present with referred ear pain or neck node metastasis before other symptoms.

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    Anatomy of Hypopharynx

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    Vasant Chaudhari
    35 views16 pages
    The hypopharynx or laryngopharynx is the lower part of the pharynx behind the larynx. It has anterior and posterior walls, and lateral walls with depressions called pyriform fossae. The pyriform fossae are sites where foreign bodies and tumors commonly lodge. The hypopharynx is supplied by nerves, blood vessels, and lymphatics and is involved in swallowing and speech. Tumors commonly occur in the pyriform fossae or postcricoid region and often present with referred ear pain or neck node metastasis before other symptoms.

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    The hypopharynx or laryngopharynx is the lower part of the pharynx behind the larynx. It has anterior and posterior walls, and lateral walls with depressions called pyriform fossae. The pyriform fossae are sites where foreign bodies and tumors commonly lodge. The hypopharynx is supplied by nerves, blood vessels, and lymphatics and is involved in swallowing and speech. Tumors commonly occur in the pyriform fossae or postcricoid region and often present with referred ear pain or neck node metastasis before other symptoms.

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    35 views16 pages

    Anatomy of Hypopharynx

    Uploaded by

    Vasant Chaudhari
    The hypopharynx or laryngopharynx is the lower part of the pharynx behind the larynx. It has anterior and posterior walls, and lateral walls with depressions called pyriform fossae. The pyriform fossae are sites where foreign bodies and tumors commonly lodge. The hypopharynx is supplied by nerves, blood vessels, and lymphatics and is involved in swallowing and speech. Tumors commonly occur in the pyriform fossae or postcricoid region and often present with referred ear pain or neck node metastasis before other symptoms.

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    of 16

    ANATOMY OF

    HYPOPHARYNX
    LARYNGEOPHARYNX
    • Laryngeopharynx or Hypopharynx is the lower part of the
    pharynx situated behind the larynx.It extends from the upper
    border of the epiglottis to the lower border of the cricoid cartilage.
    • The anterior Wall bears:
    a.The inlet of the larynx
    b. Posterior surfaces of the cricoid and arytenoid
    cartilages.
    • Posterior wall is supported mainly by the fourth and fifth cervical
    vertebrae and partly by the third and sixth vertebrae. The posterior wall is
    formed mainly by the Superior, Middle and Inferior constrictors of the
    pharynx.
    • Lateral wall presents a depression called pyriform fossa,one on each side
    PIRIFORM FOSSA
    • A deep recess which is broad above and narrow below in
    the anterior part of the lateral wall of the laryngeopharynx
    ,on either side of the laryngeal inlet
    • Produced due to the bulging of the larynx into the
    laryngeopharynx.
    BOUNDARIES
    • Medial:Aryepiglottic fold and quadrangular membrane of the larynx.
    • Lateral: Mucous membrane covering the medial surface of the lamina of
    thyroid cartilage and thyrohyoid membrane.
    The internal laryngeal nerve and superior laryngeal vessels pierce the
    thyrohyoid membrane and reaches the medial wall through the floor of the
    fossa.
    • Above: piriform fossa is seperated from epiglottic vallecula by lateral
    glossoepiglotic fold.
    CLINICAL ANATOMY

    • Sometimes foreign bodies gets lodged in these


    recess and hence they’re also known as
    Smugglers pouch.
    • The internal laryngeal nerve runs on the
    lateral wall of the sinus, which makes it
    accessible for local anaesthesia.
    • The malignant tumors of the hypopharynx
    grows in the pyriform fossa without any
    symptoms until the patient presents with
    lymphadenopathy and referred ear pain
    through the internal laryngeal nerve.
    POST CRICOID REGION.
    • Itis the part of the anterior wall of the
    laryngeopharynx between the upper and lower
    border of cricoid lamina.
    • Itextends from the level of arytenoid
    cartilage.
    • Commonsite for carcinoma in females
    suffering from Plummer-Vinson Syndrome.
    POSTERIOR PHARYNGEAL WALL
    • It extends from the level of hyoid bone to the level of cricoarytenoid joint.
    LYMPHATIC DRAINAGE.
    • pyriform sinus is richly supplied by lymphatics which exit through the
    thyrohyoid membrane and drain into the upper jugular chain.
    • Lymphatics of the posterior wall terminates in the lateral pharyngeal or
    parapharyngeal nodes and hence to the deep cervical lymph nodes.
    • Lymphatics of the post Cricoid region also drain into the
    parapharyngeal nodes.
    • They may also drain into nodes of supraclavicular and paratracheal
    chain.
    BLOOD SUPPLY
    • Hypopharynx is supplied by the pharyngeal branches of the
    superior and Inferior thyroid arteries.Venous drainage occurs
    through the pharyngeal plexus.
    NERVE SUPPLY
    • Hypopharynx is supplied by the Xth cranial nerve.
    • Sensory nerve supply to hypopharynx is by the internal branches of
    both superior laryngeal and recurrent laryngeal nerves.
    Hypopharyngeal
    tumour
    FUNCTIONS
    • It is a common pathway for air and
    food,provides a vocal tract for
    resonance of certain speech sounds
    and helps in deglutition.
    • There is coordination between
    contraction of pharyngeal muscles
    and relaxation of cricopharyngeal
    sphincter at the upper end of the
    oesophagus.
    TUMOURS OF HYPOPHARYNX
    1. Carcinoma of Pyriform Sinus:
    • Exophytic or ulcerative growth which are deeply infiltrative, which are mostly
    asymptomatic for a long time.
    • Clinically presents as metastatic neck nodes with prickling sensation in the throat.Referred
    otalgia,pain on swallowing and dysphagia are also seen in later stages.

    2. Carcinoma of Post Cricoid Region:


    • Ulcerative type lesion that are seen mostly in females with Paterson-Brown-Kelly
    (Plummer-Vinson) syndrome characterized by hypochromic microcytic anemia.

    3. Carcinoma of Posterior Pharyngeal Wall:


    • Least common, mostly seen in males above 50 yrs of age.
    • Exophytic growth but can be ulcerative.Remains localised until late and then spreads to
    prevertebral fascia,muscles and vertebrae.
    • Dysphagia or spitting of blood may be the presenting symptom.
    PHARYNGEAL POUCH
    • Also called hypopharyngeal diverticulum or Zenker’s
    diverticulum.
    • It is a pulsion diverticulum where pharyngeal mucosa
    herniates through the Killian’s dehiscence.(a weak area
    between two parts of the Inferior constrictor).
    • It is at first behind oesophagus and then comes to lie on
    its left.Mouth of the sac is wider than the opening of the
    oesophagus and food preferentially enters the sac..
    REFERENCES
    • BD Chaurasia
    • Dhingra ENT 7th Edition
    • VishramSingh

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