A case of pyriform sinus fistula infection with double tracts

Area of Science:

• Otolaryngology
• Surgical Pathology
• Pediatric Surgery

Background:

• Pyriform sinus fistula is a rare congenital anomaly, often associated with deep neck infections on the left side.
• The precise embryological origin and anatomical variations of pyriform sinus fistulas remain incompletely understood.
• Previous reports predominantly describe single-tract involvement in pyriform sinus fistula infections.

Purpose of the Study:

• To report a rare case of a pediatric patient presenting with a pyriform sinus fistula.
• To describe the unusual finding of a double-tract pyriform sinus fistula.
• To contribute to the understanding of pyriform sinus fistula anatomy and presentation.

Main Methods:

• Case report of a 13-year-old female with left-sided deep neck infection.
• Surgical exploration and resection of the entire fistulous tract.
• Detailed anatomical description of the fistula during surgery.

Main Results:

• The patient presented with acute suppurative thyroiditis and deep neck infection.
• Surgical resection revealed a previously unreported double-tract pyriform sinus fistula.
• Both tracts originated near the pyriform sinus and extended to the left thyroid lobe.

Conclusions:

• This case demonstrates a rare anatomical variation of pyriform sinus fistula with double-tract involvement.
• The findings expand the spectrum of pyriform sinus fistula presentation and surgical considerations.
• Further investigation into the embryogenesis of such double-tract anomalies is warranted.