Heyes R, Aulakh A G, Lingam R K, Tatla T
Department of Otolaryngology - Head and Neck Surgery,Northwick Park Hospital,London,UK.
Department of Radiology,Northwick Park Hospital,London,UK.
J Laryngol Otol. 2017 Oct;131(10):933-936. doi: 10.1017/S0022215117001177. Epub 2017 Jun 19.
Pyriform fossa sinus tracts classically present with neck abscess, recurrent infections and suppurative thyroiditis in children; acute presentation in a geriatric patient is rare.
Case report and Medline literature review.
A 79-year-old female presented with a left-sided neck mass and severe odynophagia of 3 days' duration. Magnetic resonance imaging revealed a large-volume, loculated fluid collection extending throughout the deep spaces of the neck on the left, within and around the thyroid gland capsule. There was radiological evidence of internal jugular vein thrombophlebitis. Abscess incision and drainage, and endoscopic evaluation, were performed. A deeply penetrating sinus was seen in the left pyriform apex, the entrance of which was circumferentially cauterised and the lumen obliterated with fibrin glue. Following post-operative intravenous antibiotics, the patient made a complete recovery.
This paper describes the first use of fibrin glue to obliterate a pyriform fossa sinus tract in an adult.
梨状窝窦道在儿童中通常表现为颈部脓肿、反复感染和化脓性甲状腺炎；老年患者出现急性症状较为罕见。
病例报告及医学文献综述。
一名79岁女性，左侧颈部肿物伴严重吞咽痛3天。磁共振成像显示，左侧颈部深部间隙、甲状腺包膜内及包膜周围有大量分叶状液体积聚。有放射学证据表明存在颈内静脉血栓性静脉炎。进行了脓肿切开引流及内镜评估。在左侧梨状窝尖部可见一深穿通性窦道，其入口进行环形烧灼，管腔用纤维蛋白胶封闭。术后静脉应用抗生素后，患者完全康复。
本文描述了首次在成人中使用纤维蛋白胶封闭梨状窝窦道的情况。
