Pyriform sinus fistula.
Pyriform sinus fistula.
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梨状窦瘘。
DOI：
10.3349/ymj.1993.34.4.386
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发表时间：
1993
影响因子：
2.4
通讯作者：
Cheong Soo Park
中科院分区：
文献类型：
--
作者：
Byeong;Cheong Soo Park
3例患者颈部引流窦与梨状窦相通，1例患者因梨状窦感染引起急性化脓性甲状腺炎。所有4例病例均存在中度至重度甲状腺周围炎症。发病年龄7 ~ 18岁（平均12岁），确诊年龄9、15、18、67岁。3例患者为男性，3例病例涉及左侧。所有患者均曾多次复发宫颈脓肿，复发次数为2 ~ 7次（平均4次）。特征性临床表现为：1）发病年龄小; 2）瘘口未完全切除时易复发; 3）反复切开引流后出现颈部引流窦。据推测，瘘管是主要在甲状腺周围间隙并随后进入甲状腺的感染途径。当瘘管直接与甲状腺相通时，可引起原发性急性化脓性甲状腺炎。慢性颈部引流窦伴反复切开引流史可能是诊断的线索。放射学检查可选择钡剂吞咽检查，治疗可选择完全切除瘘管。
Three patients had cervical draining sinus communicating with the pyriform sinus and one patient had acute suppurative thyroiditis resulting from infection through the pyriform sinus. There was a moderate to severe perithyroidal inflammation in all 4 cases. The age of onset ranged from 7 to 18 years old (mean; 12) but that of confirmation 9, 15, 18 and 67 years of age. Three of the patients were male and 3 of the cases involved the left side. All patients had suffered from several recurrences of cervical abscess, ranged from 2 to 7 times (mean; 4). Characteristic clinical features included 1) onset at a young age 2) frequent recurrence unless the fistula was extirpated completely 3) presenting with cervical draining sinus after repeated incision and drainage. It is supposed that the fistula is a route of infection mainly in the perithyroidal space and subsequently into the thyroid gland. When the fistula communicates directly with the thyroid gland, it can cause primary acute suppurative thyroiditis. Chronic cervical draining sinus with histories of repeated incision and drainage may be the clue to the diagnosis. A barium paste swallow study is the radiologic procedure of choice and complete removal of the fistula is the treatment of choice.