단일기관에서의 이상와 누공에 대한 경험

석준호; 안동빈; 손진호; 최진혁; 정윤영; 공지선

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자료유형: 학술저널

저자정보: 석준호 안동빈 손진호 최진혁 정윤영 공지선

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제56권 제3호

발행연도: 2013.1

수록면: 154 - 158 (5page)

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Background and Objectives Pyriform sinus fistula with 3rd and 4th branchial cleft anomaly is an extremely rare congenital condition that is not very well understood owing to its rarity. The aim of the study was to review our experience with pyriform sinus fistulae to better understand them. Subjects and Method Of 163 patients with branchial anomaly treated at our institute between 1999 and 2011, medical records of 15 patients with pyriform sinus fistula were retrospectively reviewed. Results Overall, 9.2% had pyriform sinus fistulae and this proportion was higher than that of patients with 1st branchial anomaly. The mean age at the time of initial symptom presentation was 11.9 years. However, five patients (33.3%) were not diagnosed at that time because pyriform sinus fistula was not suspected. Computed tomography (CT) was the most sensitive diagnostic tool in patients suspected to have pyriform sinus fistulae; the sensitivity of CT was 86.7%, whereas that for esophagography was only 20%. Conservative surgical treatment involving cauterization of the opening of the fistula tract was performed in nine patients and showed favorable results with 22.2% of recurrence rate during a mean follow-up period of 23.1 months. In 67.7% of the patients, the causative organisms were bacteria inhabiting human mouth, suggesting that infection source for pyriform sinus fistula may be food contents and discharge of upper aerodigestive tract. Conclusion The incidence of pyriform sinus fistula may be higher than expected. Therefore, the possibility of pyriform sinus fistulae coexisting should be considered while treating young patients with perithyroidal infection.

#Branchial cleft anomalies #Fistula #Pyriform sinus #Trichloroacetic acid.

참고문헌 (15)

참고문헌 신청

Cha W / 2013 / Chemocauterization of the internal opening with trichloroacetic acid as first-line treatment for pyriform sinus fistula / Head Neck 35 (3) : 431 ~ 435

Drumm AJ / 1989 / Congenital neck masses / Am Fam Physician 39 (1) : 159 ~ 163

Finn DG / 1987 / First branchial cleft cysts: clinical update / Laryngoscope 97 (2) : 136 ~ 140

Jordan JA / 1998 / Endoscopic cauterization for treatment of fourth branchial cleft sinuses / Arch Otolaryngol Head Neck Surg 124 (9) : 1021 ~ 1024

Kim KH / 2000 / Pyriform sinus fistula: management with chemocauterization of the internal opening / Ann Otol Rhinol Laryngol 109 (5) : 452 ~ 456