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Recurrent suppurative thyroiditis due to fourth branchial pouch sinus.

F Tovi, A Gatot, J Bar-Ziv

    International Journal of Pediatric Otorhinolaryngology
    |June 1, 1985
    PubMed
    Summary

    Acute suppurative thyroiditis in children can stem from rare internal pharyngeal fistulas. Surgical removal of these fistulas effectively resolves recurrent thyroiditis, highlighting a key cause and treatment.

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    Area of Science:

    • Pediatric Endocrinology
    • Otolaryngology
    • Surgical Pathology

    Background:

    • Acute suppurative thyroiditis is an uncommon pediatric condition with often unclear origins.
    • Pharyngeal pouch fistulas, specifically those extending from the pyriform sinus to the thyroid, are implicated in some cases.
    • Understanding the embryological basis, such as caudal branchial pouch remnants, is crucial for identifying etiopathogenesis.

    Observation:

    • This report details a case of recurrent suppurative thyroiditis caused by an internal pharyngeal fistula.
    • Clinical, radiological, and pathological data were collected throughout the patient's presentation and treatment.
    • The fistula tract extended from the pyriform sinus to the thyroid gland.

    Findings:

    • An internal pharyngeal fistula originating from the pyriform sinus was identified as the cause of recurrent suppurative thyroiditis.

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  • Complete surgical excision of the fistula was performed.
  • The patient's recurrent thyroiditis resolved post-operatively.

    • Implications:

    • Internal pharyngeal fistulas, particularly those related to caudal branchial pouch remnants, represent a significant, albeit rare, cause of pediatric suppurative thyroiditis.
    • Diagnostic awareness and surgical intervention for these fistulas are essential for effective management.
    • This case underscores the importance of considering congenital anomalies in the differential diagnosis of recurrent pediatric thyroid infections.