TITLE:
Chronic Pyriform Sinus-Pleural-Mediastinal Fistula Secondary to an Internal Penetrating Trauma by a Toothbrush
AUTHORS:
Qing Cheng, Banghua Liu, Jibao Wang
KEYWORDS:
Hypopharynx; Esophageal Perforation; Penetrating Wounds
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.3 No.2,
March
27,
2014
ABSTRACT: Objective: To report an
unusual case of pyriform sinus-pleural-mediastinal fistula secondary to
internal penetrating trauma by a toothbrush, with emphasis on management
options. Case report: A 26-year-old
woman swallowed a toothbrush in a violent manner 8 months ago in an attempt of
self-mutilation. She immediately complained of neck pain and dysphagia. She was
diagnosed with pyriform sinus-pleural-mediastinal fistula. The fistula was
repaired. Primary closure was performed and covered
with the sternocleidomastoid muscle flap, and reinforced with thyroid tissue
and surrounding tissues. The patient did not present any complications or
recurrence, and she gained weight after the operation. Conclusion: Early recognition of hypopharyngeal perforation is
important, and in selected cases, immediate repair of the perforation can lead
to a good prognosis.