Journal of Otology & RhinologyISSN: 2324-8785

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Case Report, J Otol Rhinol Vol: 3 Issue: 6

Recurrent Thyroid Abscess Secondary to Pyriform Sinus Fistula: An Underlying Pathology for an Uncommon Disease

Hashem M. Al-Momani1, Ayman Mismar2*, Raed N. Al-Taher1,Tareq Mahafzah3, Khalid Al-Zaben4 and Mahmoud Mustafa4
1Department of Surgery, Division of Pediatric Surgery, The University of Jordan Hospital, Faculty of Medicine, Amman, Jordan
2Department of Surgery, Division of Endocrine Surgery, The University of Jordan, Faculty of Medicine, Amman, Jordan
3Department of Special Surgery, Division of Otorhinolaryngology, The University of Jordan Hospital, Faculty of Medicine, Amman, Jordan
4Department of Anesthesia, The University of Jordan, Faculty of Medicine, Amman, Jordan
*Corresponding author : Ayman Mismar
P.O. Box: 13764, Amman 11942, Jordan
Tel: +962 799060822;
E-mail: [email protected]
Received: June 11, 2014 Accepted: August 25, 2014 Published: August 27, 2014
Citation: Al-Momani HM, Mismar A, Al-Taher RN, Mahafzah T, Al-Zaben K, et al. (2014) Recurrent Thyroid Abscess Secondary to Pyriform Sinus Fistula: An Underlying Pathology for an Uncommon Disease. J Otol Rhinol 3:6. doi:10.4172/2324-8785.1000188

Abstract

Secondary to Pyriform Sinus Fistula: An Underlying Pathology for an Uncommon

Introduction: Thyroid gland is very resistant to microbial infection, and whenever this happens, the presence of underlying pathology should be raised, especially with recurrent thyroid abscess. Presentation of Case: We report a clinical case of a 10 year old male child presented with recurrent thyroid abscess and diagnosed as a pyriform sinus fistula on the clinical grounds confirmed by esophagography and Computed tomography. The patient was treated by excision of the fistulous tract along with the involved thyroid tissue after an inflammation-free period. Surgery resulted in complete resolution and cure. Discussion: Although rare, there are a few reported cases in the literature discussing the entity of pyriform sinus fistula as a cause of recurrent thyroid abscess or suppurative thyroiditis. Strong clinical suspicion is the key to the diagnosis. Fistulogram could be confirmative especially when performed in an inflammatory-free period, and helps the surgeon to direct the plan of management. Surgical excision of the fistulous tract with hemithyroidectomy or lobectomy is the management of choice. Conclusion: Pyriform sinus fistula should be kept in mind as an underlying cause of n cases of recurrent thyroid abscess or suppurative thyroiditis.

Keywords: Thyroid abscess; Pyriform sinus fistula; Branchial cleft anomalies

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