Piriform Sinus Fistula (PSF) in an adult treated by a minimally invasive approach

Adult occurrence of a piriform sinus fistula (PSF) is extremely rare. We present a case of a 47-year-old female who presented with a 1-week history of pain and swelling on the left side of neck and difficulty in swallowing with fever to our hospital who also had two similar episodes in the past three months which were treated with antibiotics. Contrast-enhanced computed tomography (CECT) and Magnetic resonance imaging (MRI) scans revealed a left thyroid abscess and an associated sinus tract on the left side. Electrocautery using an endoscope mounted suspension laryngoscope and suction diathermy was performed. Successful closure of the sinus tract was achieved and the patient remains symptom free at follow up with endoscopy revealing no residual tract opening in the piriform fossa.