Piriform Fossa

recessus piriformis

The piriform fossa (piriform recess or sinus) is a pear-shaped gutter on each side of the laryngeal inlet in the laryngopharynx. It lies between the aryepiglottic fold medially and the thyroid cartilage and thyrohyoid membrane laterally. Swallowed food and fluid flow through these channels around the larynx into the oesophagus.

Anatomical Data

Structure & Supply

Location	Laryngopharynx, on each side of the laryngeal inlet, medial to the thyroid cartilage lamina
Parts	Aryepiglottic fold (medial wall) Thyroid cartilage and thyrohyoid membrane (lateral wall) Apex Mucosa over the internal laryngeal nerve
Nerve Supply	Internal laryngeal nerve, CN X (sensory)
Blood Supply	Superior laryngeal artery
Venous drainage	Superior laryngeal vein
Lymphatic drainage	Deep cervical nodes

Biomechanics

Function & Actions

Acts as a side channel that directs swallowed material around the laryngeal inlet and into the oesophagus.

Clinical Relevance

Clinical Notes

Sharp foreign bodies such as fish bones often lodge here. The internal laryngeal nerve runs just beneath the lining, so it can be numbed by topical anaesthetic for awake procedures and can be injured by a foreign body. Pooling of saliva in the piriform fossae on endoscopy is a sign of significant swallowing dysfunction.

Pathology

Common Injuries & Conditions

Foreign Body Impaction

Fish or chicken bones lodging in the piriform fossa, causing localised pain on swallowing that may need endoscopic removal.

Piriform Sinus Carcinoma

The most common site of hypopharyngeal cancer, often advanced at diagnosis because the fossa can hide a large tumour.

Piriform Sinus Fistula

Congenital tract from the apex of the fossa, usually on the left, that causes recurrent neck abscesses or acute suppurative thyroiditis.

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