IJOHNS  Vol.3 No.2 , March 2014
Chronic Pyriform Sinus-Pleural-Mediastinal Fistula Secondary to an Internal Penetrating Trauma by a Toothbrush
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.


Cite this paper
Cheng, Q. , Liu, B. and Wang, J. (2014) Chronic Pyriform Sinus-Pleural-Mediastinal Fistula Secondary to an Internal Penetrating Trauma by a Toothbrush. International Journal of Otolaryngology and Head & Neck Surgery, 3, 95-100. doi: 10.4236/ijohns.2014.32019.
References
[1]   Berry, B.E. and Ochsner, J.L. (1973) Perforation of the Esophagus: A 30 Year Review. The Journal of Thoracic and Cardiovascular Surgery, 65, 1-7.

[2]   Stanley Jr., R.B., Armstrong, W.B., Fetterman, B.L., et al. (1997) Management of External Penetrating Injuries into Hypopharyngeal-Cervical Esopbageal Funnel. Journal of Trauma, 42, 675-679.
http://dx.doi.org/10.1097/00005373-199704000-00016

[3]   Moberly, A.C., Fritsch, M.H. and Mosier, K.M. (2011) Management of Sword-Swallower Injuries. The Journal of Laryngology & Otology, 125, 217-219. http://dx.doi.org/10.1017/S002221511000215X

[4]   Moriwaki, Y., Arata, S. and Iwashita, M. (2011) A Case of Cervical Esophageal Perforation after Transnasal Gastrointestinal Fibroscopy Using a Small-Caliber Fiber. Endoscopy, 43, E147-E148.
http://dx.doi.org/10.1055/s-0030-1256211

[5]   Choudhary, A.M., Roberts, I. and Gupta, T. (1999) Hypopharyngeal Perforation from a Swallowed Fork: A Brief Report and Comment. Connecticut Medicine, 63, 539-540.

[6]   Engum, S.A., Grosfeld, J.L., West, K.W., et al. (1996) Improved Survival in Children with Esophageal Perforation. Archives of Surgery, 131, 604-610. http://dx.doi.org/10.1001/archsurg.1996.01430180030005

[7]   Foley, M.J., Ghahremani, G.G. and Rogers, L.F. (1982) Reappraisal of Contrast Media Used to Detect Upper Gastrointestinal Perforations. Radiology, 144, 231-237.

[8]   Christey, G.R. (2005) Blunt Handlebar Injury Causing Pharyngeal Perforation. Injury Extra, 36, 373-375.
http://dx.doi.org/10.1016/j.injury.2004.11.024

 
 
Top