Prenatal diagnosis of pyriform sinus fistula using ultrasonography by detecting the communication to the pharynx

Taiwan J Obstet Gynecol. 2022 Mar;61(2):385-387. doi: 10.1016/j.tjog.2022.02.035.

Abstract

Objective: Pyriform sinus fistula (PSF) is a congenital anomaly which originates from the pharyngeal pouch. PSF is initially recognized as a cyst around the fetal neck, but accurate prenatal diagnosis of the disease is challenging. We aimed to report the key findings and tips in accurately distinguishing PSF from other differential diagnosis by which enables detection of the communication of the nuchal cyst and the pharynx.

Case report: We report a case in which we were able to diagnose PSF as early as 18 weeks of gestation with ultrasonography. We used epiglottis as a landmark, and detected an unilobular cyst arising from the pharynx.

Conclusion: Ultrasonography is a powerful tool in prenatal diagnosis of PSF especially at early stage of pregnancy. By detecting the epiglottis, it can locate the communication of the nuchal cyst and the pharynx, and thereby enables an accurate diagnosis of PSF.

Keywords: Nuchal cyst; Prenatal diagnosis; Pyriform sinus fistula; Ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Fistula* / congenital
  • Fistula* / diagnostic imaging
  • Humans
  • Pharynx / diagnostic imaging
  • Pregnancy
  • Prenatal Diagnosis
  • Pyriform Sinus* / abnormalities
  • Pyriform Sinus* / diagnostic imaging
  • Ultrasonography