Tight near-total corrosive strictures of the proximal esophagus with concomitant involvement of the hypopharynx: Flexible endoscopic management using a novel technique

Figure 1 Anatomical consideration while addressing hypopharyngo-esophageal strictures endoscopically. A: The normal anatomy of the adult hypopharynx as seen during flexible endoscopy, with the scope tip behind the epiglottis. The piriform sinuses are 2 inverted pyramids on either side of the larynx with their apex inferiorly at the level of cricopharyngeus muscle (CP); they are bounded medially by the aryepiglottic folds and laterally by the pharyngeal wall; B: Post-cricoid region extends from the level of arytenoid cartilages (joined by the inter-arytenoid muscle in the midline) superiorly to the inferior border of cricoid cartilage (vertical dashed green lines); C: The strictured proximal esophagus and hypopharynx in both of our cases. The fibrotic process in both extended cranially till the proximal aspect of the post-cricoid region; there was an involvement of the apical parts of piriform sinuses as well (not shown here).