If fitted appropriately and its cuff is inflated, the lower end of LMA[TM] resides at the level of the upper esophageal sphincter with its sides pressing the piriform fossa
and upper end extending to the base of the tongue.
They present as a sinus tract with a proximal opening in the floor of the piriform fossa
; from there they extend upward for various distances in the neck.
Although neck tenderness is commonly observed, it is not a reliable sign of impaction.2 Within the regions of the upper aerodigestive tract, palatine tonsil, posterior tongue and vallecula are common sites of suprahyoid impaction and piriform fossa
, larynx, cricopharyngeus, cervical oesophagus and thoracic oesophagus are less common sites of infrahyoid impaction.3
Branchial sinus of the piriform fossa
: reappraisal of third and fourth branchial anomalies.
Under a hard laryngoscope, we found an exogenous lesion occupying the entire right piriform fossa
with the right fixed vocal fold.
This demonstrated that the large pedunculated necrotic mass was in fact, appearing to arise from the right piriform fossa
and not the tonsil confirmed by rigid pharyngolaryngo-upper oesophagoscopy.
The most common sites of fish bone impaction are the tonsils, tonsillar pillars, tongue base, valleculae, and piriform fossa
. Impaction in the supraglottic area is extremely uncommon.
CONCLUSION: During routine dissection we do come across such intriguing and fascinating objects (like--Fabella, Stones in the gall bladder, Foreign body in the nose or Piriform fossa
; Syndactyly, Polydactyly, etc.) and the impressionable mind of students seeks an answer to such curious findings.
On flexible laryngoscopy, a small left pharyngocele was seen at the thyrohyoid membrane just above the thyroid cartilage and piriform fossa
Intraluminally, this area is located in the area of the base of the piriform fossa
. (2,5,9,14) When certain mechanical factors are present, bulging of the mucous membrane may occur and become exaggerated over time.
(5) Foreign bodies can become lodged in the tonsil, base of the tongue, piriform fossa
, and cervical esophagus.
The cyst extended superiorly up to the tip of the epiglottis, medially overlying the glottic chink, and laterally filling the left piriform fossa
. The lower extent of the cyst could not be discerned.