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Stage I Entering The Right Pyriform Sinus

Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The operator standing
(as in Fig. 66), inserts the esophagoscope along the right side of the
tongue as far as and down the posterior pharyngeal wall. A lifting
motion imparted to the tip of the esophagoscope by the left thumb will
bring the rounded right arytenoid eminence into view (A, Fig. 69).
This is the landmark of the pyriform sinus, and care must be taken to
avoid injury by hooking the tube mouth over it or its fellow. The tip
of the tube should now be directed somewhat toward the midline,
remembering the funnel shape of the hypopharynx. It will then be found
to glide readily through the right pyriform sinus for 2 or 3 cm., when
it comes to a full stop, and the lumen disappears. This is the
spasmodically closed cricopharyngeal constriction.

[FIG. 66.--Esophagoscopy by the author's high-low method. First
stage. High position. Finding the right pyriform sinus. In this and
the second stage the patient's vertex is about 15 cm. above the level
of the table.]

Next: Stage 2

Previous: Introduction Of The Esophagoscope

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