A Case of Right Piriform Sinus Fistula Accompanied by a Very Large Mediastinal Cyst

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A female neonate, 22 days after birth, was examined due to swelling of the right neck as the primary symptom. MRI showed a cystic mass of about 60-mm long, stretching from the right neck to mediastinum. Since the mass tended to enlarge, surgery was performed 9 months after birth. Prior to surgery, rigid bronchoscopy was carried out, and she was diagnosed with right piriform sinus fistula. A guide-wire was placed in the fistula lumen, and the fistula and cyst were completely resected by a right collar incision of the neck. Right vocal cord paralysis occurred as a postoperative complication. Piriform sinus fistula, although rare, is a differential diagnosis of a cystic mediastinal mass that extends to the neck. In its surgical treatment, attention must be paid to avoid injury of the laryngeal recurrent nerve.
特定非営利活動法人日本小児外科学会の論文