F P Lee1. 1. Department of Otolaryngology, Taipei Medical College, 252 Wu-Hsing Street, Taipei,110, Taiwan.
Abstract
BACKGROUND: Congenital pyriform sinus fistula (CPSF) is a rare branchial pouch anomaly; it has the characteristic of left-sided predominance and is not always detected until complications such as neck abscess or acute suppurative thyroiditis resulted. METHOD: Seven sequential cases of CPSF, including five adults and two children, causing recurrent left lower neck abscess were reported. All of these patients had past histories of misdiagnosis: the intervals from the onset of symptoms to correct diagnosis ranged from 3 years to 34 years with an average of 20 years. RESULTS: After barium swallow study and direct laryngoscopic examination in the quiescent stage of infection, the CPSFs of these seven patients were successfully excised with or without catheter guide. CONCLUSION: The key to diagnosis of CPSF is a high index of suspicion by the clinician. CPSF should be considered in the differential diagnosis of a neck abscess, especially if it is recurrent and left-sided. Copyright 1999 John Wiley & Sons, Inc. Head Neck 21:671-676, 1999.
BACKGROUND:Congenital pyriform sinus fistula (CPSF) is a rare branchial pouch anomaly; it has the characteristic of left-sided predominance and is not always detected until complications such as neck abscess or acute suppurative thyroiditis resulted. METHOD: Seven sequential cases of CPSF, including five adults and two children, causing recurrent left lower neck abscess were reported. All of these patients had past histories of misdiagnosis: the intervals from the onset of symptoms to correct diagnosis ranged from 3 years to 34 years with an average of 20 years. RESULTS: After barium swallow study and direct laryngoscopic examination in the quiescent stage of infection, the CPSFs of these seven patients were successfully excised with or without catheter guide. CONCLUSION: The key to diagnosis of CPSF is a high index of suspicion by the clinician. CPSF should be considered in the differential diagnosis of a neck abscess, especially if it is recurrent and left-sided. Copyright 1999 John Wiley & Sons, Inc. Head Neck 21:671-676, 1999.
Authors: Christopher M Gibbs; Francis C Nichols; Jan L Kasperbauer; Eric A Jensen; Gianrico Farrugia Journal: Dig Dis Sci Date: 2004-09 Impact factor: 3.199