title: Preoperative identification of the internal opening with the modified Killian's method in a case of pyriform sinus fistula.
abstract: Pyriform sinus fistula is a rare branchial pouch anomaly, which causes recurrent neck abscess. Although complete excision of the fistula tract is considered as a definitive treatment for pyriform sinus fistula, it has been suggested that chemocauterization with trichloroacetic acid (TCA) of the internal opening is a reasonable treatment. For this purpose identifying the existence of an internal opening is important. Here, we describe the Modified Killian's method, a recently proposed simple endoscopic technique to observe a wider area of the hypopharyngeal space, and show that it is helpful to identify the internal opening of the pyriform sinus fistula. The Modified Killian's method is a suitable examination for pyriform sinus fistula prior to TCA chemocauterization.
authors.affiliation: Department of Otolaryngology, Tonami General Hospital, Tonami, Japan; Department of Otolaryngology, Head and Neck Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kano
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kanazawa University, Kanazawa, Japan. Electronic address: murono@med.kanazawa-u.ac.jp.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Murono
authors.affiliation: Department of Otolaryngology, Tonami General Hospital, Tonami, Japan.
authors.forename: Tamaki
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000293:Adolescent; D002424:Caustics / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic; D004724:Endoscopy; D005260:Female; D005402:Fistula / Q000628:therapy*; D006801:Humans; D056888:Patient Positioning / Q000379:methods*; D011300:Preoperative Care; D056144:Pyriform Sinus; D012399:Rotation; D014238:Trichloroacetic Acid / Q000008:administration & dosage; D014636:Valsalva Maneuver
chemical_list: D002424:Caustics; D014238:Trichloroacetic Acid