Piriform recess

The piriform recess (piriform fossa) is a pear-shaped mucosal depression located on either side of the laryngeal inlet within the laryngopharynx.

• The recess extends from the pharyngoepiglottic fold superiorly to the oesophageal inlet inferiorly and functions as a channel that directs food and liquids around the laryngeal opening during swallowing, thereby helping to protect the airway.

• Medially, it is bounded by the aryepiglottic fold and the laryngeal inlet, while

• Laterally it is related to the thyroid cartilage and thyrohyoid membrane. Deep to the mucosa of the lateral wall lie the internal laryngeal nerve and the superior laryngeal vessels, making these structures vulnerable to injury.

Clinical correlates

• The piriform recess is an important site where foreign bodies, particularly fish bones, may become lodged. Attempts at removal can damage the internal laryngeal nerve, resulting in loss of sensation above the vocal folds and an impaired cough reflex, increasing the risk of aspiration.

• The piriform recess is also a common site for hypopharyngeal squamous cell carcinoma.