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Preoperative identification of the internal opening with the modified Killian's method in a case of pyriform sinus
Makoto Kano1, Shigeyuki Murono2, Tamaki Yamamoto3
1Department of Otolaryngology, Tonami General Hospital, Tonami, Japan; Department of Otolaryngology, Head and Neck Surgery, Kanazawa University, Kanazawa, Japan.
Abstract:
Pyriform sinus fistula is a rare branchial pouch anomaly, which causes recurrent neck abscess. Although complete excision of the fistula tract is considered as a definitive treatment for pyriform sinus fistula, it has been suggested that chemocauterization with trichloroacetic acid (TCA) of the internal opening is a reasonable treatment. For this purpose identifying the existence of an internal opening is important. Here, we describe the Modified Killian's method, a recently proposed simple endoscopic technique to observe a wider area of the hypopharyngeal space, and show that it is helpful to identify the internal opening of the pyriform sinus fistula. The Modified Killian's method is a suitable examination for pyriform sinus fistula prior to TCA chemocauterization.
