2022 Volume 73 Issue 1 Pages 14-20
Piriform sinus fistula is a congenital internal fistula and is relatively rare. Surgical treatment is the first choice for piriform sinus fistula and three methods have been reported : fistulotomy through an external neck incision, transoral fistula cautery and transoral videolaryngoscopic surgery (TOVS). A 13-year-old boy presented to our hospital with left anterior neck pain and fever. Ultrasonography revealed acute pyogenic thyroiditis, and the patient was treated with puncture drainage and antibiotics. After the inflammation was improved, hypopharyngeal esophagography revealed a 1 cm fistula tract running from the left piriform, leading to the diagnosis of a piriform fistula. TOVS was performed under general anesthesia. The postoperative course was good and there has been no recurrence to date. TOVS is a less invasive treatment without any skin incision. Moreover, the resected mucosa is sutured and the infection route is closed after resection of the fistula. TOVS is considered to be a highly curative procedure.
