Vol.96 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.5 May 2003
A Case of Hypopharyngeal Fistula Suspected of
Late Complication Due to Irradiation
Teruhiko Fuchigami, Takehiro Karaho, Yoshihiro Hyodo,
Tetsuya Tanabe and Satoshi Kitahara
(National Defense Medical College)
We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case.
Key words : hypopharyngeal fistula, late complication after irradiation, endoscopic laser surgery