Abstract
A male neonate presented a soft mass at the anterior left side of the neck and developed a cyanosis soon after his first bathing. Chest X-rays revealed pneumothorax in the left side. A CT scan of the neck showed that a huge cyst contained air and his trachea was dislocated by compression of the mass. Symptoms of airway obstruction spontaneously improved with oxygen supplement in a incubator. After reduction of local inflammation by IV antibiotics, he was referred to us at three months of age. A barium swallow test showed a communication between the left piriform sinus and the cyst through a draining fistula. Diagnosis was confirmed as a cervical cyst communicating a piriform sinus fistula. One month later we excised the cyst and fistula. A number of reported neonatal cases of a piriform sinus fistula associated with airway obstruction are increasing. But this is the first case associated with nneumothorax in the same side.
