A NEW OPERATIONAL APPROACH FOR THE PIRIFORM SINUS FISTULA

It has been well documented that piriform sinus fistulae often cause s uppurative thyroditis; however, when a piriform sinus fistula does not present this symptom, making a correct diagnosis is very difficult. W e have experienced 11 cases of a piriform sinus fistula. The conventio nal operational approach was performed in the initial eight patients, among which there were four recurrences in two patients. Therefore, a new operational approach was introduced for the three most recent case s and one recurrent case. First, the existence of the internal orifice of the fistula is confirmed with a laryngoscope, after which a transv erse incision on the neck is made and the abscess dissected. The side wall of the piriform sinus is then opened with the help of a laryngosc ope and the bottom part of the mucosa of the sinus transected with the internal orifice of the fistula, after which the fistula is removed e n bloc with the bottom part of the sinus and abscess cavity. Using thi s operation, we experienced no complications and there has been no rec urrence so far.