Retrospective case review of pyriform sinus fistulae of third branchial arch origin commonly presenting as acute suppurative thyroiditis in children
Retrospective case review of pyriform sinus fistulae of third branchial arch origin commonly presenting as acute suppurative thyroiditis in children
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DOI：
10.1017/s0022215112000898
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发表时间：
2012-07-01
影响因子：
1.7
通讯作者：
Krishnapriya, S.
中科院分区：
文献类型：
--
作者：
Yolmo, D.;Madana, J.;Krishnapriya, S.
目的：第三鳃弓的异常较第二鳃弓少见，通常表现为左侧甲状腺小叶炎症。方法：回顾分析2000~2008年收治的15例梨状窝瘘，均为左侧复发性甲状腺脓肿。方法：回顾分析2000~2008年收治的15例梨状窝瘘的临床资料，均根据瘘道的组织病理学和放射学证据，诊断为瘘管切除合并左侧甲状腺肿块。术前超声、计算机断层扫描、瘘管造影和吞钡检查均显示左侧有第三弓形瘘管。所有病例均在术中和病理检查中发现了瘘管。手术(所有病例均成功)强调完整的喉返神经和同侧梨状窝显露，以方便切除，左半甲状软骨切除。结论：儿童因甲状腺脓肿引起的反复下颈炎发作，尤其是左侧甲状腺脓肿，应引起梨状窝瘘的怀疑。
Objective: Abnormalities of the third branchial arch are less common than those of the second arch and usually present with left thyroid lobe inflammation. This paper describes 15 cases of pyriform sinus fistulae of third branchial arch origin usually presenting as recurrent thyroid abscess on the left side.Method: A retrospective review of 15 cases of third arch fistulae managed 2000 and 2008, diagnosed based on histopathology and radiological evidence of a fistulous tract, and treated with fistulectomy with left hemithyroidectotmy.Results: All patients (six boys and nine girls, aged three to 15 years) presented with recurrent low neck inflammation. Pre-operative ultrasound, computed tomography fistulography and barium swallow demonstrated a third arch fistulous tract, left-sided in all cases. The fistula was detected intra-operatively and pathologically in all cases. Surgery (successful in all cases) emphasised complete recurrent laryngeal nerve and ipsilateral pyriform sinus exposure, to facilitate tract excision, with left hemithyroidectomy. There was no recurrence over three to five years' follow up.Conclusion: Paediatric recurrent low neck inflammatory episodes, due to thyroidal abscess, especially left-sided, should raise suspicion of pyriform sinus fistulae.