Nine cases of piriform sinus fistula with acute suppurative thyroiditis
Introduction
Acute suppurative thyroiditis is an inflammatory disease of the thyroid gland. Although this disease had long been thought to be rare, an increased number of cases has been reported in recent years. These reports have indicated that for the majority of cases of acute suppurative thyroiditis, the infection originates from the piriform sinus of the hypopharynx and spreads to the thyroid gland via a congenital fistula. In this paper, we describe nine cases of acute suppurative thyroiditis treated at our department, and investigate the accurate diagnosis and complete treatments.
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Subjects
Between January 1981 and December 2000, nine patients with acute suppurative thyroiditis were treated at the Department of Otorhinolaryngology, Yamada Red Cross Hospital. Acute suppurative thyroiditis was diagnosed by the suppurative symptoms of the neck, inflammatory biochemical data, and congenital fistula originated from the piriform sinus that was confirmed by pharyngoesophagography. There were four males and five females.
Results
The age of these patients ranged from 2.5 to 71 years (median age, 17 years) at the time of the operation (Table 1). Three cases had only one episode of the suppuration. The remaining six patients had experienced two to four episodes of suppuration previously and received surgical drainage of the anterior neck mass at other hospitals.
Discussion
Acute suppurative thyroiditis, first reported by Hazard [1], has been considered to be rare; however, the number of case reports have increased in recent years [2], [3]. The clinical characteristics of this disease have been demonstrated by several investigators [2], [3], [4], [5]. It has been reported that the suppurative inflammation occurred between the age of 3 to 63-years-old, and the majority of the patients were less than 15-years-old of age (Table 2, [2], [3], [4], [5], [6]).
Most of our
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Coexistence of pyriform sinus fistula, ectopic lingual thyroid, and ectopic cervical thymus
2012, Auris Nasus LarynxCitation Excerpt :The ectopic cervical thymus anomalies occur as a consequence of an arrest in normal thymic descent [9,10]. The pyriform sinus fistula may appear as recurrent acute anterior neck swelling including suppurative thyroiditis and abscesses [3–6]. In the present case, pyriform sinus fistula caused recurrent cervical abscess without thyroiditis because the thyroid gland was not in a normal pretracheal position.
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