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Endoscopic electrocautery and fibrin obliteration of an acutely complicated pyriform fossa sinus tract in a septuagenarian

Published online by Cambridge University Press:  19 June 2017

R Heyes ,
A G Aulakh ,
R K Lingam  and
T Tatla
R Heyes*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Northwick Park Hospital, London, UK
A G Aulakh
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Northwick Park Hospital, London, UK
R K Lingam
Affiliation:
Department of Radiology, Northwick Park Hospital, London, UK
T Tatla
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Northwick Park Hospital, London, UK
*
Address for correspondence: Mr Richard Heyes, Department of Otolaryngology – Head and Neck Surgery, Northwick Park Hospital, London HA1 3UJ, UK Fax: +44 (0)208 869 5283 E-mail: r.heyes@hotmail.com
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Abstract

Background:

Pyriform fossa sinus tracts classically present with neck abscess, recurrent infections and suppurative thyroiditis in children; acute presentation in a geriatric patient is rare.

Methods:

Case report and Medline literature review.

Case report:

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.

Conclusion:

This paper describes the first use of fibrin glue to obliterate a pyriform fossa sinus tract in an adult.

Keywords

Pyriform Fossa Sinus TractSuppurative ThyroiditisLemierre's SyndromeFibrinAdult
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 10 , October 2017 , pp. 933 - 936
Copyright
Copyright © JLO (1984) Limited 2017 

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