Abstract
Piriform sinus fistula is a relatively rare congenital condition that often causes acute suppurative thyroiditis and neck abscess among young people. The radical treatment for this condition includes a fistulectomy using a cervical approach or, recently, chemocauterization of the internal opening of the fistula by direct endoscopy. In general, radical treatment can be performed only at a certain interval after reduction of inflammation. A 9-year-old boy suffering from swelling and tenderness of the anterior neck was referred to our hospital. Two weeks after reduction of inflammation by incising the neck to drain the abscess, we performed a fistulectomy. Identification of the fistula is the most important step in obtaining a successful surgical result. We were not able to confirm the fistula in the operating field by staining. However, insertion of a wire probe into the fistula allowed detection of the fistula and facilitated the fistulectomy. This method is supposed to be very effective to identify a piriform sinus fistula in the inflammatory tissue.
