J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 4238KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 80(10): 948-954, 1979

Original article

PYRIFORM-SINUS FISTULA AS A CAUSE OF ACUTE SUPPURATIVE THYROIDITIS

*) The Second Department of Surgery, Osaka University Medical School
**) Kuma Hospital

Akira Miyauchi*), Fumio Matsuzuka**), Shin-ichiro Takai*), Masao Uematsu*), Ichiro Kobayashi*), Shintaro Shinya*), Hitoshi Shiozaki*), Yuichi Takatsuka*), Kanji Kuma**), Goro Kosaki*)

Seven cases of acute suppurative thyroiditis were reported. Two cases were male and 5 were female. The age at onset ranged from 4 to 10 years in 6 cases, and the remaining case was 56 years old at the onset. The symptoms and signs including thyroid scan were indistinguishable from those of reported cases of acute suppurative thyroiditis. Six cases had had repeated episodes of inflammation in the left anterior neck. A careful search of hypopharynx by barium swallowing examination revealed a fistula originating from the apex of the left pyriform sinus in all cases. The fistula, a remnant of 3rd pharyngeal pouch, is considered the route of infection in these cases. The infection through this fistula resulted in accumulation of purulent exudate in the perithyroidal space. Then the thyroid gland was involved by direct invasion. Complete removal of the fistula is essential for a permanent cure.

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