title: [Diagnosis and management of congenital pyriform sinus fistula].
abstract: OBJECTIVE
  To explore the clinical presentation and management principles of congenital pyriform sinus fistula.
  
  
  METHODS
  Seven sequential cases of congenital pyriform sinus fistula (CPSF) treated between January 2007 and January 2011 were reported. The clinical presentation were recurrent left lower neck abscess or acute suppurative thyroiditis. All of these patients had past histories of misdiagnosis ranged from 3 years to 11 years. All the patients had undergone incision and drainage several times. In acute infection period, these patients received incision and drainage, after inflammation subsided, were treated with definitive surgery.
  
  
  RESULTS
  After barium swallow study and CT examination in the quiescent stage of infection, 5 patients could be seen fistula in the pyriform, all the patients were found scar tissue near the left thyroid lobe, 4 patients received direct laryngoscope examination and 3 of them could be found inner orifice near the apex of pyriform sinus, fistula and the involved lobe of thyroid were successfully excised without permanent recurrent laryngeal nerve injury or hypothyroidism. All the patients had an uneventful recovery and remained symptom free from 5 months to 40 months.
  
  
  CONCLUSIONS
  The clinical history of recurrent low neck inflammatory episodes in patients, especially on the left side, should raise the suspicion of CPSF, investigation using barium swallow in combination with CT scanning is useful. CPSF can be treated by excising the fistula and involved lobe of thyroid.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Jian-zhong
authors.initials: JZ
authors.lastname: Sang
authors.forename: Wu-hao
authors.initials: WH
authors.lastname: Lu
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Lou
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005402:Fistula / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010608:Pharyngeal Diseases / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D055815:Young Adult