A Case of Piriform Sinus Fistula with Foreign Body Sensation in the Neck

Piriform sinus fistulae usually manifest as acute suppurative thyroiditis or abscess of the neck. In this paper, we reported a case of piriform sinus fistula with a chief complaint of foreign body sensation in the neck. The patient, 25-year-old female, was seen to our clinic on October 20th, 1987 complaining of foreign body sensation in the neck deviated to the left side with about two months duration. She had neither a history of acute suppurative thyroiditis or abscess of the neck. The indirect laryngoscopy revealed no abnormality of piriform sinus of both sides, but the hypopharyngo-esophagography demonstrated the abnormal shadow arising from the left piriform sinus. She was diagnosed as the piriform sinus fistula. The resection of the fistular canal was performed successfully under general anesthesia on July 26th, 1988. Histological examinations revealed that the lumen of the fistular canal was lined by the normal squamous cell epithelia. Inflammatory cell infiltration of moderate degree was observed in the subepithelial layer at the proximal portion of the canal. However, the canal was obliterated with the inflammatory granulation tissue at the distal end. These findings indicated the existence of the masked infection of the fistular canal that could be the cause of foreign body sensation in the neck. There have been no reports on piriform sinus fistula with a chief complaint of foreign body sensation in the neck.