2011 Volume 15 Issue 3 Pages 310-318
We report a patient admitted for the deep cervical abscess and diagnosed with piriform sinus fistula during rehabilitation for swallowing disorder. The patient was a 65-year-old man, in whom painful swelling occurred in the left neck, and a cervical abscess was diagnosed. After admission, mediastinitis concomitantly developed, and drainage was emergently performed. Swallowing disorder was recognized after surgery, and so the patient underwent rehabilitation. On videofluoroscopic examination of swallowing, failure of the laryngeal elevation, pharyngeal constriction, and opening of the esophageal orifice were observed, and these were assumed to be due to inflammation and postoperative scarring. Balloon bousie was effective for the impaired opening of the esophageal orifice. The patient underwent balloon training in parallel with eating training, and mostly recovered the capability of ingesting conventional food within about 1 month. The piriform sinus fistula was observed on videofluoroscopy after recovery, and identified as the cause of the cervical abscess. Piriform sinus fistula should be suspected especially in cases of cervical abscess with no underlying disease. Balloon bousie was effective for swallowing disorder following surgery for a cervical abscess.
