Abstract
Pyriform sinus fistula can be a potential infection route for suppurative thyroiditis, which, in cases with repetitive abscess formation, need therapy. We experienced a case in which both abscess drainage and fistula excision were successfully performed simultaneously. In this case, which was for a 26-year-old patient, the first attempt to remove the fistula was done two months after abscess formation. But a scar tissue mimicking a fistula tract was mistakenly excised at the first operation; then, abscess formations were repeated 2.5 and 5 years after the operation. As an early resolution was required by the patient, we performed the second operation to excise the fistula and abscess drainage simultaneously. Because the abscess naturally separated the larynx from adjacent scar tissue, a good visualization of the pyriform sinus was easily obtained with an excision of the upper pole of the left thyroid gland, so that the fistula excision was made successfully. We will discuss the optimal timing of a fistula excision and abscess formation with our other cases.
