CPT® Code 42892

Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls

The procedure described by CPT® Code 42892 involves the surgical resection of the lateral wall of the pharynx or the pyriform sinus, followed by direct closure of the surgical site through the advancement of the lateral and posterior pharyngeal walls. The pyriform sinus, also known as the pyriform fossa, is a funnel-shaped recess located in the anterolateral wall of the nasopharynx, adjacent to the vestibule of the larynx. This surgical intervention is primarily indicated for the treatment of malignant tumors affecting the pharynx or pyriform sinus, although it may also be utilized for the excision of benign lesions or strictures that may obstruct normal function. The procedure begins with a horizontal incision made in the neck, specifically over the thyrohyoid membrane, allowing access to the underlying structures. The suprahyoid muscles are carefully separated from the hyoid bone laterally to facilitate exposure of the pharynx. By retracting the larynx inferiorly and the tongue superiorly, the surgeon gains access to the valleculae and the lateral pharynx, where the lesion or defect is identified. The excision of the lesion is performed with a margin of healthy tissue to ensure complete removal. Following the resection, the defect is closed by mobilizing the lateral and posterior pharyngeal walls, which are then approximated and sutured together to restore the integrity of the pharyngeal structure.