Retrospective review of 70 cases of pyriform sinus fistula

Zhao, Limin; Chen, Le; Li, Wanpeng; Ni, Kun; Chen, Wei; Li, Xiaoyan

doi:10.1016/j.ijporl.2021.110904

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…The initial symptoms of PSF include neck mass with or without abscess, acute thyroiditis, and thyroid lesion [1][2][3]. In some cases, particularly in neonates, a neck mass compressing the surrounding structure, resulting in dyspnea, has been reported [2,4].…”

Section: Discussionmentioning

confidence: 99%

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Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: A case report

Otsuki

Onuma

Tonsho

et al. 2023

Preprint

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Background Pyriform sinus fistulas (PSFs) are rare congenital anomalies of the third or fourth brachial clefts. Dyspnea is reportedly secondary to compression by a neck mass. However, hoarseness, as the first symptom of PSF, has not yet been reported. Case presentation This report describes an eleven-year-old girl presenting with hoarseness as the first symptom of PSF. Hoarseness occurred 2 days prior to admission. On admission, she had fever, hoarseness, and an elastic soft mass on her left anterior neck. Contrast-enhanced computed tomography of the cervical region demonstrated an abscess partially infiltrating the thyroid gland and an air pocket near the pyriform sinus. Pharyngoscopy revealed swelling of the left arytenoid region, with purulent retention. The left vocal cord was swollen but not paralyzed. Additionally, the laboratory data indicated thyrotoxicosis. Suspecting a PSF infection, parenteral treatment with cefotaxime and dexamethasone was initiated. On the following day, the hoarseness disappeared, and the fever resolved. Four weeks after onset, the thyroid hormone levels returned to the normal range, and a barium esophagogram revealed residual contrast in the left pyriform sinus, leading to a diagnosis of PSF. Conclusion PSF presenting with hoarseness as the first symptom in patients should be considered.

show abstract

Section: Discussionmentioning

confidence: 99%

“…PSFs often present with recurrent fever, neck pain, and swelling near the thyroid gland. They more commonly occur in neonates and young children and do not differ by sex [2,3].…”

Section: Introductionmentioning

confidence: 97%

Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: A case report

Otsuki

Onuma

Tonsho

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The initial symptoms of PSF include neck mass with or without abscess, acute thyroiditis, and thyroid lesion [ 1 – 3 ]. In some cases, particularly in neonates, a neck mass compressing the surrounding structure, resulting in dyspnea, has been reported [ 2 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…PSFs often present with recurrent fever, neck pain, and swelling near the thyroid gland. They more commonly occur in neonates and young children and do not differ by sex [ 2 , 3 ]. The left side of the neck is the predominantly affected site.…”

Section: Introductionmentioning

confidence: 99%

Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: a case report

et al. 2023

View full text Add to dashboard Cite

Background Pyriform sinus fistulas (PSFs) are rare congenital anomalies of the third or fourth brachial pouch. Dyspnea is reportedly secondary to compression by a neck mass. However, hoarseness, as the first symptom of PSF, has not yet been reported. Case presentation This report describes an 11-year-old girl presenting with hoarseness as the first symptom of PSF. Hoarseness occurred 2 days prior to admission. On admission, she had fever, hoarseness, and an elastic soft mass on her left anterior neck. Contrast-enhanced computed tomography of the cervical region demonstrated an abscess partially infiltrating the thyroid gland and an air pocket near the pyriform sinus. Pharyngoscopy revealed swelling of the left arytenoid region, with purulent retention. The left vocal cord was swollen but not paralyzed. Additionally, the laboratory data indicated thyrotoxicosis. Suspecting a PSF infection, parenteral treatment with cefotaxime and dexamethasone was initiated. On the following day, the hoarseness disappeared, and the fever resolved. Four weeks after onset, the thyroid hormone levels returned to the normal range, and a barium esophagogram revealed residual contrast in the left pyriform sinus, leading to a diagnosis of PSF. Conclusion PSF presenting with hoarseness as the first symptom in patients should be considered.

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“…The typical presentations of lesions in pyriform sinus fistula are recurrent low‐neck abscesses, acute suppurative thyroiditis, and neck masses. 14 , 15 , 16 Approximately, 90% of these sinus tracts are situated on the left side of the neck, which may be due to embryonic development. 17 , 18 , 19 An internal fistula is usually located at the tip or base of the pyriform fossa.…”

Section: Introductionmentioning

confidence: 99%

A safe and effective surgical method for complex pyriform sinus fistula

Yue

Lei

et al. 2022

Laryngoscope Investig Oto

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Objective This article aims to propose a new surgical method for the treatment of pyriform fistula, especially for the complex pyriform fistula. Methods A total of 36 patients with pyriform fistula underwent the procedure between August 2017 to October 2020. Surgery was performed by the senior authors using the same technique at the same clinical center for all patients. The median follow‐up time was 33 months. Meantime, we collected information on patients with pyriform fistula using traditional surgical methods in our hospital from April 2015 to November 2018 for comparison. Results The surgery was successfully completed in 36 patients. In all, 32 patients had a history of multiple incisions and drainage, 16 patients had a history of surgical resections, and two patients had a history of cauterization of the internal fistula. Compared with traditional surgical methods, our new surgical method greatly shortens the length of the surgical incision (4.3 vs. 5.5, p < 0.0001), reduces the operation time (8.1 vs. 27.1, p < 0.0001), and reduces the blood loss (103.2 vs. 196.8, p < 0.0001). None of the 36 patients in this study had complications such as pharyngeal fistula, recurrent laryngeal nerve paralysis, or hypothyroidism. The mean follow‐up duration after the excision of the lesion was 34.1 months. To date, no patients have relapsed. Conclusion Our experience showed that this surgical technique could be used to completely remove the fistula, and it was easier to perform than the conventional strategies. These treatment options result in less trauma and reliable results, especially for complex pyriform fistulas. Level of evidence IV

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Retrospective review of 70 cases of pyriform sinus fistula

Cited by 6 publications

References 26 publications

Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: A case report

Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: A case report

Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: a case report

A safe and effective surgical method for complex pyriform sinus fistula

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