Surgical strategy for the treatment of pyriform sinus fistula

Kubota, Masayuki; Suita, Sachiyo; Kamimura, Tetsuro; Zaizen, Yoshio

doi:10.1016/s0022-3468(97)90087-7

Cited by 42 publications

(36 citation statements)

References 5 publications

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“…Nonetheless, the persistence of third or fourth pharyngeal pouch as the pyriform sinus fistula can lead to thyroid abscesses due to the common embryological origin [2][3][4][5][6][7]. Pyriform sinus fistula is the least common branchial apparatus malformation and AST resulting due to its occurrence has been reported as anecdotal case reports or short case series in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Obliteration of the internal opening may present as lateral cervical cysts. A vast majority (87-95%) of the lesions occur on the left side of the neck and this is possibly related to asymmetry of the fourth branchial arch to form the aortic arch and innominate artery [6,7]. The diminished growth of ultimobranchial body on the right side may also contribute for the same.…”

Section: Discussionmentioning

confidence: 99%

“…Repeat barium studies may be required to demonstrate the tract after resolution of acute infection [12]. Proper delineation of the anomaly is required preoperatively as complete excision of the sinus with high ligation of fistula close to pharynx is essential to prevent recurrence [5,7]. In cases of acute presentation as an inflammatory mass, broad-spectrum antibiotics are administered as infecting organisms are from the oral flora [2].…”

Section: Discussionmentioning

confidence: 99%

“…During the surgical dissection the tract should be followed unto the pharyngeal opening and high ligation of the fistula is to be performed [5,7]. Incision of the inferior pharyngeal constrictor aid in delineating the internal opening and obviates pharygotomy and injury to surrounding nerves.…”

Section: Discussionmentioning

confidence: 99%

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Acute suppurative thyroiditis in children secondary to pyriform sinus fistula

et al. 2007

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Acute suppurative thyroiditis (AST), a potential complication of pyriform sinus fistula (PSF), is a rare clinical condition as the thyroid gland is remarkably resistant to infections. Lack of awareness of the entity contributes to the rarity and frustrating recurrences. We performed a retrospective review of all cases of AST due to PSF treated at our institution over a 10-year period. The clinical data, investigations, operative findings and procedures, microbial culture reports and follow-up were recorded and analyzed. Between January 1997 and September 2006, 12 cases (8 males and 4 females) of AST due to PSF were treated. Nine patients (75%) underwent successful complete excision, seven of whom had initial incision and drainage procedures. In three patients (25%) with recurrence, one underwent complete excision at a later procedure, one patient had multiple recurrences with six incision and drainage procedures and two failed attempts of excision of PSF before final successful complete excision. The third patient is awaiting re-excision of the PSF tract. All patients, except the one awaiting re-excision, are well with no further recurrences during the follow-up period that ranged from 18 to 96 months (median, 46.5 months). AST due to PSF is a challenging entity in terms of diagnosis and management as recurrences are common despite meticulous dissection. High index of suspicion and radiological investigations such as barium studies and computed tomography scan aid in the delineation and excision of the fistulous tract.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute suppurative thyroiditis in children secondary to pyriform sinus fistula

et al. 2007

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“…There is potential risk of respiratory dysfunction and thyroiditis in view of pyriform sinus fistula lying closer to airway and thyoid gland [1]. Prenatal recognition is extremely rare and limited to patients with cystic lesions [2].…”

Section: Introductionmentioning

confidence: 99%

Pyriform Sinus Fistula Presenting as Fetal Cervical Cyst

Hirose¹,

Satô²,

Imai³

et al. 2017

JCR

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Background: Pyriform sinus fistula, congenital anomaly originating from the third or fourth brachial pouch remnant, rarely occurs during the prenatal period. Case Report: A pregnant woman was referred to our hospital at 30 weeks of gestation with ultrasonographic finding of fetal cervical cyst. Fetal ultrasonography had revealed a left unilocular cystic lesion in neck.. Although it remained unchanged in size, deviation of the trachea by the cyst was later demonstrated by magnetic resonance imaging. A male child was born with a good Apgar score by elective cesarean delivery. Mild respiratory dysfunction was resolved by immediate cyst aspiration. Our diagnosis was pyriform sinus fistula with subcutaneous cyst formation based on catheterization performed under laryngoscopy. Our hospital pediatric surgeons removed the cyst and fistula, and the postoperative course was uneventful. Conclusion: The possibility of pyriform sinus fisuta must be kept in mind for fetal cystic lesions of neck.

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