Diagnosis and management of congenital pyriform sinus fistula
10.3760/cma.j.issn.1673-0860.2011.09.006
- VernacularTitle:先天性梨状窝瘘管的诊断与治疗
- Author:
Jian-Zhong SANG
1
;
Wu-Hao LU
;
Wei-Hua LOU
Author Information
1. 郑州大学附属第一医院
- Keywords:
Fistula;
Hypapharynx;
Branchial region;
Congenital abnormalities;
Abscess
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2011;46(9):728-732
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical presentation and management principles of congenital pyriform sinus fistula. Methods Seven sequential cases of congenital pyriform sinus fistula (CPSF) treated between January 2007 and January 2011 were reported. The clinical presentation were recurrent left lower neck abscess or acute suppurative thyroiditis. All of these patients had past histories of misdiagnosis ranged from 3 years to 11 years. All the patients had undergone incision and drainage several times. In acute infection period, these patients received incision and drainage, after inflammation susided, were treated with definitive surgery. Results After barium swallow study and CT examination in the quiescent stage of infection, 5 patients could be seen fistula in the pyriform, all the patients were found scar tissue near the left thyroid lobe, 4 patients received direct laryngoscope examination and 3 of them could be found inner orifice near the apex of pyriform sinus, fistula and the involved lobe of thyroid were successfully excised without permanent recurrent laryngeal nerve injury or hypothroidism. All the patients had an uneventful recovery and remained symptom free from 5 months to 40 months. Conclusions The clinical history of recurrent low neck inflammatory episodes in patients, especially on the left side, should raise the suspicion of CPSF,investigation using barium swallow in combination with CT scanning is useful. CPSF can be treated by excising the fistula and involved lobe of thyroid.
