**Hypopharyngeal tumors:**

The hypopharynx extends from the level of hyoid bone superiorly to the level of cricoid cartilage inferiorly and consists of three parts: pyriform sinus, postcricoid area, and posterior pharyngeal wall. Tumors arising in the hypopharynx are most often localizing in the piriform sinus. Hypopharyngeal cancers are usually silent and grow to a significant size to cause symptoms; the central core can be necrotic.

**Presentation**: it is usually very late. Progressive dysphagia and late onset hoarseness.

**Airway Management:** given the potential for airway obstruction with apnea, a wake intubation is the most appropriate course.

