Observation of curative effect of endoscopic chemocauterization and mucosal suturing closure of the internal opening for treatment of pyriform sinus fistula

Abstract

Objective To evaluate the effectiveness of endoscopic cauterization and mucosal suturing surgical management in the treatment of pyriform sinus fistula. Methods From March 2012 to December 2014, 16 patients were performed endoscopic closure of pyriform sinus fistula by mucosal suturing. All patients were treated with endoscopic cauterization and mucosal suturing. Patients presenting with acute neck abscess were processed simultaneously with surgical management of incision and drainage. There were 9 males and 7 females. The ages ranged from 6 to 54 years old. The lesions were predominantly left sided (13/16), and generally presented as acute suppurative thyroiditis (9/16) or recurrent neck abscess (5/16), two patients presented with pharyngocutaneous fistula following ipsilateral thyroidectomy. Among them, 11 patients showed acute neck infections or pharyngocutaneous fistula at the time of hospitalization. Results Two weeks post-operation, telescopic hypopharyngoscopy was employed to confirm the closure of the internal opening in all patients, and they all presented with the formation of scar tissue at piriform fossa. Following external incision and drainage, all cases presenting with acute neck abscess recovered within two weeks. Except one case presented with slight thyroiditis and rapidly recovered after antibiotic treatment, there were no serious complications and no recurrence within the follow-up period ranging from 13 to 41 months. Conclusions Endoscopic mucosal suturing closure of the internal opening is a safe and effective treatment for pyriform sinus fistula patients. Patients presenting with acute neck abscess should be processed simultaneously with incision and drainage. Key words: Fistula; Pyriform sinus; Laryngoscopic surgical procedures; Chemocauterization; Suture