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Acute suppurative thyroiditis is an uncommon condition because the thyroid gland is remarkably resistant to infections. In children, anatomic defects, such as a left piriform sinus fistula, predispose subjects to this infection. The number of reports on acute suppurative thyroiditis and an anterior neck abscess due to piriform sinus fistula have recently increased. The sinus may be overlooked for years, with the patient receiving multiple procedures before a proper diagnosis is made and the condition correctly treated. Herein, we report our experience of a case of recurrent suppurative thyroiditis associated with piriform sinus fistula, and reviews the embryological development of the sinus, as well as clinical symptoms and treatment of acute suppurative thyroiditis. (J Korean Surg Soc 2006;70:470-474)
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