Abstract
A 7-year-old girl suffering from fever and swelling of the anterior neck was referred to our hospital. The patient was admitted and was diagnosed with purulent thyroiditis. She was administered antibiotics intravenously and thyroiditis was cured. Barium meal roentgenogram demonstrated left-sided pyriform sinus fistula. The pyriform sinus fistula was supposed to be the route of infection in this case. Two months later, she developed thyroiditis again. The patient and her parents decided that she should undergo surgery.
During the operation, initially, direct esophagoscopy was conducted. The orifice of the pyriform sinus fistula could be identified in the apex of the pyriform sinus. Dye was instilled in the pyriform sinus fistula. This method enabled us to distinguish the pyriform sinus fistula from surrounding tissues without any difficulty in the operating field. We conducted only a fistelectomy without thyroidectomy. The postoperative course was uneventful and she has shown no recurrence. This method is supposed to be very effective to identify a pyriform sinus fistula.
