A study of piriform sinus fistula cases

Hatakeyama, Hyōe; Homma, Akihiro; Nagahashi, Tatsumi; Yagi, Katsunori; Fukuda, Satoshi; Inuyama, Yukio

doi:10.1016/s0385-8146(01)00079-7

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…In this study, the mean diagnostic delay was 12.28 months. Similar to our results, the mean diagnostic delay in the literature ranged from 6 to 18 months (7,(28)(29)(30). Overall, the diagnostic delay could be categorized as patients' delay in seeking medical care and doctors' delay in making an accurate diagnosis.…”

Section: Discussionsupporting

confidence: 87%

Pyriform Sinus Fistula in Children: Preferred Imaging Modality and Risk Factors for Diagnostic Delay

Chen

et al. 2020

Front. Pediatr.

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Background: Diagnostic delay of pyriform sinus fistula (PSF) continues to challenge clinicians, and the preferred imaging modality is yet to be verified. The purpose of this study was to investigate the preferred imaging modality for PSF and the possible risk factors for a longer diagnostic delay. Methods: Medical records of patients with a surgically confirmed PSF from 2014 to 2018 were retrospectively evaluated. A comparison of the first esophagography timing with a true-positive (TP) result and that with a false-negative (FN) result was made. Data of computed tomography (CT) performed immediately after esophagography were also analyzed. In addition, the factors related to diagnostic delay were analyzed using multivariate regression models. Results: A total of 147 patients ranging in age from 0 to 16 years (median: 5.2 years) were included. The mean time since the symptom onset of the first esophagography with TP result was significantly longer than that of the examination with FN result (95.18 ± 79.12 vs. 52.59 ± 42.40 days, P = 0.032). When the time since the symptom onset was less than 12 weeks, the false-negative rate (FNR) of the first esophagography was declining dramatically with a longer time interval. Among 18 cases with an FN result of the first esophagography, the fistulous tract was finally identified in seven cases using an immediate CT. The mean of diagnostic delay was 12.28 months. Besides, rural residency was an independent risk factor for a longer diagnostic delay. Conclusion: Joint examination of esophagography and an immediate CT is the preferred imaging modality for the diagnosis of PSF in children. It is inadvisable to perform the first esophagography when the time since the symptom onset is less than 12 weeks. Besides, the rural residency is an independent risk factor for a longer diagnostic delay.

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Section: Discussionsupporting

confidence: 87%

Pyriform Sinus Fistula in Children: Preferred Imaging Modality and Risk Factors for Diagnostic Delay

Chen

et al. 2020

Front. Pediatr.

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“…Several reports documented incidental discoveries of fourth branchial arch anomalies during laryngoscopy, laryngectomy, and MRI. Misdiagnoses of esophageal perforation [8], thyroid cancer [10], thyroid cyst, or ruptured diverticulum [11] were also documented.…”

Section: Diagnostic Investigationsmentioning

confidence: 99%

Management of congenital fourth branchial arch anomalies: a review and analysis of published cases

Nicoucar

Giger

Pope

et al. 2009

Journal of Pediatric Surgery

213

295

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“…Some authors reported the usefulness of air contrast computed tomography wherein air was used as a contrast agent in patients who drank carbonated water instead of barium. 26,27 If clinically the diagnosis of PFS is suspected but imaging modalities have failed to confirm the diagnosis, direct pharyngoscopy under general anesthesia to identify the internal opening of the sinus tract within the pyriform fossa should be performed. A simple maneuver such as squeezing the neck mass while observing the hypopharynx for secretions may also help to identify the internal orifice.…”

Section: Discussionmentioning

confidence: 99%

“…CECT performed shortly after the barium swallow study is helpful in delineating the sinus tracts by showing high‐density points along the course of the tracts. Some authors reported the usefulness of air contrast computed tomography wherein air was used as a contrast agent in patients who drank carbonated water instead of barium 26,27 . If clinically the diagnosis of PFS is suspected but imaging modalities have failed to confirm the diagnosis, direct pharyngoscopy under general anesthesia to identify the internal opening of the sinus tract within the pyriform fossa should be performed.…”

Section: Discussionmentioning

confidence: 99%

Deep Neck Infections of Congenital Causes

Nour

Hassan

Gaafar

et al. 2010

Otolaryngol.--head neck surg.

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Computed tomography is helpful in diagnosing infected congenital cysts and its types. Infected congenital cysts could be excised completely under an umbrella of antibiotics. Recurrence of deep neck infections should alert the physician to the possibility of underlying congenital lesions. Thorough clinical and radiological assessment is mandatory to rule out the possibility of a congenital pyriform fossa sinus.

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A study of piriform sinus fistula cases

Cited by 9 publications

References 10 publications

Pyriform Sinus Fistula in Children: Preferred Imaging Modality and Risk Factors for Diagnostic Delay

Pyriform Sinus Fistula in Children: Preferred Imaging Modality and Risk Factors for Diagnostic Delay

Management of congenital fourth branchial arch anomalies: a review and analysis of published cases

Deep Neck Infections of Congenital Causes

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