Stage I Entering The Right Pyriform Sinus

Sources: 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.]