Pyriform sinus

The pyriform sinus (also piriform recess, piriform sinus, piriform fossa, or smuggler's fossa) is a small recess on either side of the laryngeal inlet. It is bounded medially by the aryepiglottic fold, and laterally by the thyroid cartilage and thyrohyoid membrane.[1] The fossae are involved in speech.

Pyriform sinus
Pyriform sinus, a part of hypopharynx
The entrance to the larynx, viewed from behind, with Pyriform sinus labeled at bottom left.
Details
Identifiers
Latinrecessus piriformis, sinus piriformis
MeSHD056144
TA98A05.3.01.024
TA22880
FMA55067
Anatomical terminology

Etymology

The term "pyriform," which means "pear-shaped," is also sometimes spelled "piriform".

The term smuggler's fossa comes from its use for smuggling of small items.[2]

Anatomy

Relations

Deep to the mucous membrane of the pyriform fossa lie the recurrent laryngeal nerve as well as the internal laryngeal nerve, a branch of the superior laryngeal nerve.[3] The internal laryngeal nerve supplies sensation to the area, and it may become damaged if the mucous membrane is inadvertently punctured. The pyriform sinus is a subsite of the hypopharynx. This distinction is important for head and neck cancer staging and treatment.[4]

Clinical significance

This sinus is a common place for food particles to become trapped; if foreign material becomes lodged in the piriform fossa of an infant, it may be retrieved nonsurgically. If the area is injured (e.g., by a fish bone), it can give the sensation of food stuck in the subject's throat.[2]

Remnants of the pharyngeal pouches III and IV may extent to the piriform sinus as sinus tracts which are sometimes imprecisely called "fistulas".[5][6] This can result in acute infectious thyroiditis which is more common on the left side of the neck.[7]

References

Public domain This article incorporates text in the public domain from page 1142 of the 20th edition of Gray's Anatomy (1918)

  1. Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). New York. p. 709. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  2. Singh, Vishram (4 March 2014). Textbook of Anatomy Head, Neck, and Brain;. Elsevier Health Sciences. p. 203. ISBN 978-81-312-3627-7.
  3. Moore, K.L., & Agur, A.M.R (2007). Essential Clinical Anatomy: Third Edition. Baltimore: Lippincott Williams & Wilkins. ISBN 978-0-7817-6274-8
  4. AJCC Cancer Staging Handbook: From the AJCC Cancer Staging Manual, Sixth Edition. Ed. Frederick L. Greene, M.D. page 48.
  5. Koch, Bernadette L.; Hamilton, Bronwyn E.; Hudgins, Patricia A.; Harnsberger, H. Ric (22 November 2016). Diagnostic Imaging: Head and Neck E-Book. Elsevier Health Sciences. p. 611. ISBN 978-0-323-44314-2.
  6. Lucente, Frank E.; Har-El, Gady (2004). Essentials of Otolaryngology. Lippincott Williams & Wilkins. pp. 281–2. ISBN 978-0-7817-4707-3.
  7. Gorbach, Sherwood L.; Bartlett, John G.; Blacklow, Neil R. (2004). Infectious Diseases. Lippincott Williams & Wilkins. p. 462. ISBN 978-0-7817-3371-7.
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