Abstract
In the case of piriform sinus fistula, it is sometimes difficult to identify the fistula opening on the pharynx side by conventional endoscopic inspection. We report a case in which the modified Killian （MK） method was useful for identifying the fistula opening. A 55-year-old woman had undergone left hemithyroidectomy for left piriform sinus fistula. Twenty years later, she showed left anterior neck swelling which was suspected to be a recurrence of the piriform sinus fistula. The fistula opening of the pharynx could be identified by the MK method, but not by endoscopy in the normal position. Under general anesthesia, the fistula opening was successfully closed by an oral approach. There has been no recurrence until 1 year 4 months after the surgery. The MK method is useful for identifying the fistula opening of the pharynx even in the case of recurrent piriform sinus fistula.
