Transient hyperthyroidism secondary to acute suppurative thyroiditis caused by pyriform sinus fistula

2011 ◽  
Vol 6 (4) ◽  
pp. 203-205
Author(s):  
Hrvoje Mihalj ◽  
Marinela Rosso ◽  
Josip Maleš ◽  
Mario Štefanić
Keyword(s):  
Pyriform Sinus ◽  
Suppurative Thyroiditis ◽  
Pyriform Sinus Fistula ◽  
Acute Suppurative Thyroiditis

scholarly journals Outcomes of endoscopic chemo- and laser-cauterizations and open fistulectomy for pyriform sinus fistula

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Hiroo Masuoka ◽  
Akira Miyauchi ◽  
Takahiro Sasaki ◽  
Tsutomu Sano ◽  
Akihiro Miya
Keyword(s):  
Mouth Opening ◽  
Pyriform Sinus ◽  
Barium Swallow ◽  
Success Rates ◽  
Suppurative Thyroiditis ◽  
Endoscopic Procedures ◽  
Pyriform Sinus Fistula ◽  
Lower Blood ◽  
Acute Suppurative Thyroiditis ◽  
The Individual

Abstract Background Acute suppurative thyroiditis through the congenital pyriform sinus fistula (PSF) often recurs if the fistula is not resected. Although endoscopic chemo-cauterization (ECC) to obliterate the orifice of the fistula is less invasive than open fistulectomy, it may require repeated treatments. We recently adopted an endoscopic diode laser-cauterization (ELC) system with the intention of improving treatment outcomes in PSF. Here, we describe ELC and compare the outcomes of these three modalities. Methods We evaluated 83 patients with PSF who underwent treatment between 2007 and 2018 at Kuma Hospital, a tertiary thyroid treatment hospital. ECC and ELC were implemented in 2007 and 2015, respectively. Patients who were ineligible for the endoscopic procedures underwent open fistulectomy. Barium swallow studies and computed tomography scan under a trumpet maneuver were performed after treatment to evaluate obliteration or removal of the fistula. Results In total, 70 of the 81 (86%) patients who underwent barium swallow studies after the first treatment achieved obliteration or removal of the fistula. The success rates for open fistulectomy, ECC, and ELC were 100% (9/9), 83% (49/59), and 100% (13/13), respectively. ECC and ELC had significantly shorter operative times and lower blood loss than open fistulectomy. Insufficient opening of the mouth was the major reason for converting endoscopic procedures to open fistulectomy. Conclusions ELC may yield superior outcomes and is therefore the optimal treatment modality for PSF. However, it is still associated with certain limitations. Thus, treatment selection remains dependent on the shape and size of the PSF and the mouth opening of the individual patient.

scholarly journals Complete Pyriform Sinus Fistulas: Case Series and Review of Literature

2011 ◽  
Vol 2 (3) ◽  
pp. 134-137
Author(s):  
Sandeep Bansal ◽  
Abhishek Jaswal
Keyword(s):  
Case Series ◽  
Pyriform Sinus ◽  
Suppurative Thyroiditis ◽  
Upper Respiratory Infection ◽  
Pyriform Sinus Fistula ◽  
Fourth Arch ◽  
Acute Suppurative Thyroiditis ◽  
Neonates And Infants ◽  
Painful Neck ◽  
Branchial Anomalies

ABSTRACT Pyriform sinus fistula belongs to the rarest group of cervical fistulae accounting for 3 to 10% of all branchial anomalies.1 The first clinical and embryological studies were described in the early seventies by Sandborn and Tucker, but embryological knowledge in this field remains incomplete. Children and adults usually complaint of painful neck swelling accompanied by fever that is preceded by upper respiratory infection, otalgia and odynophagia. Neonates and infants may have respiratory distress, sometimes with stridor, due to tracheal compression by the abscess.1,5,6 However, the most common mode of presentation is the recurrent episodes of acute thyroiditis. Eighty percent of patients with recurrent acute suppurative thyroiditis due to persistent pyriform sinus fistula present during the first decade of life. Making the distinction between third and fourth arch fistulas is difficult on clinical grounds alone and hence they are often collectively termed pyriform sinus fistula. Owing to the rarity of the condition and varied clinical presentation, diagnosis and ultimate management is often delayed leading to undue morbidity to the patient and professional frustration for the treating surgeon. We, hereby, present a case series of three classical cases of complete pyriform sinus fistulas with review of available literature in an attempt to clarify issues regarding presentation, diagnosis and management of this condition.

scholarly journals A Case of Pyriform Sinus Fistula Infection with Double Tracts

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Masato Shino ◽  
Yoshihito Yasuoka ◽  
Kyoko Nakajima ◽  
Kazuaki Chikamatsu
Keyword(s):  
Deep Infection ◽  
Left Lobe ◽  
Pyriform Sinus ◽  
Deep Neck Infection ◽  
Rare Clinical Entity ◽  
Suppurative Thyroiditis ◽  
Neck Infection ◽  
Pyriform Sinus Fistula ◽  
Tract Involvement ◽  
Acute Suppurative Thyroiditis

Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

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