2024 Volume 45 Issue 2 Pages 159-163
Recently, endoscopic piriformis fistulectomy for hypopharyngeal piriform sinus fistula (PSF) has been reported. As a result, we present two cases that underwent this procedure.
Case 1: A 13-year-old boy had a history of drainage of a left cervical abscess two years before coming to our hospital. The abscess recurred one month prior to his visit, thus he was referred to our department for further evaluation and treatment. Hypopharyngeal fluorography confirmed a PSF. Two weeks before surgery, the patient received antibiotic treatment for a fever and cervical edema.
Case 2: A 6-year-old boy had a history of an abscess extending from the left pharyngeal wall to the left lobe of the thyroid gland that was drained 2 years prior to presentation. Hypopharyngeal fluorography did not reveal a PSF, but given the clinical course, a PSF was highly suspected, and the treatment was initiated.
In both cases, the PSF was easily identified by detailed endoscopic observation of the hypopharynx under general anesthesia. The mucosa around the fistula was incised with an electric needle knife, and the fistula was traced to the submucosal margin of the thyroid cartilage, which was then resected. The postoperative course was uneventful, with no complications or recurrence of abscess in either case.
