Xiao X, Zheng J, Jin B
Children's Hospital, Shanghai Medical University.
Zhonghua Wai Ke Za Zhi. 1997 Jun;35(6):354-6.
In 12 patients with piriform sinus fistula, aged from 1.5 to 10 years all but one patient presented themslves with inflammatory swelling in the region of the left lobe of the thyroid gland. During acute infection, the involvement of the left thyroid lobe was verified by ultrasonography and scintigraphy. Barium swallow examination was the diagnostic finding that all the 11 patients had a left-sided fistula. One patient presented with a painless cyst in the left thyroid lobe. Six patients operated on 4 underwent fistulectomy. In patient the fistula was not found. In the patient who had a cyst in the thyroid lobe, fistulectomy and cystectomy were done. All these patients did well postoperatively without recurrence. Six other patients were followed up without operation with in 1-6 years. Five patients remained asymptomatic. One patient had 3 recurrences during a 2 years follow-up period. Piriform sinus fistula is the most common underlying abnormality in the patients with acute suppurative thyroiditis. A better understanding about this rare branchial anomaly is of clinical importance.
12例梨状窝瘘患者年龄在1.5至10岁之间,除1例患者外,其余患者均出现甲状腺左叶区域的炎性肿胀。在急性感染期间,通过超声检查和闪烁扫描证实左甲状腺叶受累。钡剂吞咽检查发现所有11例患者均有左侧瘘管。1例患者甲状腺左叶出现无痛性囊肿。6例接受手术的患者中,4例进行了瘘管切除术。1例患者未发现瘘管。对于甲状腺叶有囊肿的患者,进行了瘘管切除术和囊肿切除术。所有这些患者术后恢复良好,无复发。另外6例患者未手术,随访1至6年。5例患者无症状。1例患者在2年随访期间复发3次。梨状窝瘘是急性化脓性甲状腺炎患者最常见的潜在异常。更好地了解这种罕见的鳃裂异常具有临床重要性。