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[Pyriform sinus fistulae].

R Martín Del Rey1, A Ortí Martín, P Gregori Roig

  • 1Sección de Infecciosos, Hospital Infantil La Fe, Valencia, Spain.

Anales Espanoles De Pediatria
|February 6, 2002
PubMed
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Pyriform sinus fistulae (PSF) are rare congenital anomalies. Early diagnosis and surgical treatment of PSF are crucial for managing cervical abscesses and thyroiditis, preventing recurrences.

Area of Science:

  • Otolaryngology
  • Surgical Pathology
  • Medical Diagnostics

Background:

  • Pyriform sinus fistulae (PSF) are uncommon congenital anomalies originating from branchial pouch remnants.
  • PSF often present as recurrent or persistent cervical inflammatory conditions, including abscesses and thyroiditis.
  • Left-sided PSF are more prevalent in reported cases.

Observation:

  • This report details two cases of acute thyroiditis and deep cervical abscesses attributed to PSF.
  • Patients presented with inflammatory cervical masses, odynophagia, fever, and signs of infection.
  • Diagnostic imaging included barium esophagography, cervical ultrasonography, and computed tomography.

Findings:

  • Barium esophagography confirmed the diagnosis of PSF in both cases.

Related Experiment Videos

  • Imaging modalities effectively visualized the fistulous tracts and associated inflammatory processes.
  • The clinical presentation mimicked other common cervical infections.

    • Implications:

    • PSF should be considered in the differential diagnosis of unexplained cervical abscesses and thyroiditis.
    • Prompt diagnosis and appropriate management, including antibiotics and surgical fistulectomy, are essential.
    • Surgical intervention offers a definitive solution, preventing recurrent infections and complications.