A Study on 11 Cases of Pyriform Sinus Fistula of the Hypopharynx

We retrospectively studied the clinical characteristics of 11 patients with pyriform sinus fistulas of the hypopharynx. The 11 patients consisted of 6 males and 5 females, aged 2–79 years, with a median of 41 years. The left side was affected in 10 cases. Six patients had a past history of acute suppurative thyroiditis. Eight patients had a severe neck abscess and had undergone incision and drainage. Fistulectomy was performed in 7 patients, with concomitant partial/hemithyroidectomy in 5 of these patients. Four patients developed recurrence after fistulectomy, whereas no recurrence was seen in any of the patients in whom no fistula was identified. The recurrence rate was 75% (3/4) in the patients who had undergone incision and drainage of the abscess, and 33% (1/3) in those who had not. In addition, the recurrence rate was 33% (1/3) in the patients in whom a fistula had been identified during the operation, and 75% (3/4) in whom a fistula had not been identified intraoperatively. The median age of the patients who developed recurrence was 23.5 years (range, 2–46 years), while that of the patients who did not develop recurrence was 56 years (range, 5–79 years).