Three Cases of Pirif orm Sinus Fistula

Abstract

Pirif orm sinus fistula is a well-known congenital deformity derived from a third, fourth or fifth branchial cleft (pharyngeal pouch). This disease often causes repeated cervical infection or acute suppurative thyroiditis. In the last five years, we experienced three cases of pirif orm sinus fistula with a symptom of neck swelling, and fortunately complete removals of the fistulae were successfully carried out. Three cases are briefly introduced herein.Case 1 was a 15-year-old female, and case 2 was an 8-year-old boy. They suffered from left neck swellings. Barium esophagographies revealed fistulas originating from the apex of the left pirif orm sinuses. These fistulae were confirmed to be pirif orm sinus fistulae before surgical intervention, and were completely resected out.Case 3 was a 4-year-old girl, showing right neck swelling and fever. In neck magnetic resonance imaging (MRI), the abscess formation in the right lobe of the thyroid gland was highly suspected. During the operation, we found that this fistula originated from the hypopharynx and entered into the thyroid gland. Therefore, we performed complete resection of this fistula together with the right lobe of the thyroid gland.All the patients have good prognoses and no recurrence has been found to date.