Where is the site for an aspirated fishbone lodging?

• A. Epiglottis
• B. Vallecula
• C. Vestibule
• D. Piriform recess

Answer: (D)

When a foreign body is aspirated, it tends to settle where the airway anatomy creates a narrow, dependent pocket. The piriform recess is a narrow, funnel-shaped pocket on each side of the laryngopharynx, formed around the laryngeal inlet by the thyroid cartilage and thyrohyoid membrane. This recess catches objects that pass the epiglottis during swallowing, especially slender items like fishbones, because its geometry provides a natural trap that can be difficult to access and remove. The epiglottis protects the airway during swallowing, while the vallecula is a space between the tongue and epiglottis and is less likely to retain a sharp object. The vestibule lies above the vocal cords, not at the level where a fishbone typically lodges. Thus the most likely site for an aspirated fishbone to lodge is the piriform recess.