Congenital piriform sinus fistula, which is usually unilateral, is recognized as a cause of acute suppurative thyroiditis. We have encountered a rare case of bilateral piriform sinus fistulae. The patient, a 53-year-old female, was referred to our hospital because of right neck swelling, which improved after conservative treat. Three months later, an abscess of the left thyroid lobe was presented and was improved after incision and drainage. The diagnosis of bilateral piriform sinus fistulae was made by hypopharyngeal enhancement radiography. Total fistulectomies were performed. There was no recurrence observed six months after surgery.
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