Revista de otología y rinología

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

Hashem M. Al-Momani, Ayman Mismar, Raed N. Al-Taher, Tareq Mahafzah, Khalid Al-Zaben and Mahmoud Mustafa

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.