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A study of piriform sinus fistula cases
H Hatakeyama1, A Homma, T Nagahashi
1Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo, Japan. htkym@med.hokudai.ac.jp
Abstract:
We have experienced five cases of piriform sinus fistula for the last 10 years. It is a relatively rare disease, and partly because of poor understanding of the disease, in one case infection had repeatedly recurred without being adequately treated for over 20 years, and in most cases there was a long time lapse before the diagnosis. In another case, it was difficult to image the fistula with contrast medium and fistulectomy was performed without identifying it on imaging. We have applied various devices to those cases where imaging of fistula was difficult, and achieved complete resection of fistula and have not observed recurrences of infection after resection.
Insights
Piriform sinus fistula is a rare condition often diagnosed late due to poor understanding. Advanced imaging techniques and surgical resection can effectively treat this condition, preventing recurrent infections.
Area of Science:
- Otolaryngology
- Surgical Innovation
Background:
- Piriform sinus fistula is a rare congenital anomaly.
- Delayed diagnosis and inadequate treatment contribute to recurrent infections.
Observation:
- Five cases of piriform sinus fistula were treated over 10 years.
- Challenges included delayed diagnosis, prolonged infections, and imaging difficulties.
- One case involved fistulectomy without pre-operative imaging identification.
Findings:
- Various devices were employed to overcome imaging challenges.
- Complete fistula resection was achieved in all cases.
- No recurrent infections were observed post-operatively.
Implications:
- Improved diagnostic approaches are crucial for piriform sinus fistula.
- Effective surgical management can prevent long-term complications.
- This study highlights successful treatment strategies for a rare condition.