Prenatal diagnosis and sequential interventions of neonatal pyriform sinus cyst: a report of 16 cases

Abstract

Objective To explore the significance of prenatal diagnosis, multidisciplinary team (MDT) consultations and sequential interventions in reducing perioperative complications and improving the prognosis of neonatal pyriform sinus cyst (PSC). Methods A total of 16 neonatal PCS cases were retrospectively analyzed between January 2011 and April 2016. They were assigned into the groups of prenatal diagnosis (PreD, n=8) and postnatal diagnosis (ProD, n=8) depending on whether or not prenatal information was available. And MDT consultations and sequential interventions were offered. Perioperative complications, perioperative management and prognosis were compared for two groups. Results There was no mortality case. One patient (12.5%) was drained due to preoperative respiratory distress in PreD group versus 7 patients (87.5%) in ProD group. And the differences were statistically significant. None required preoperative intubation in PreD group and intubation was required for 2 patients (25%) in ProD group. The mean postoperative duration of mechanical ventilation was significantly shorter in PreD group than that in PostD group (11.50±13.88 & 100.71±80.04 h respectively, P=0.0089). And the mean total course was significantly longer in PostD group than that in PreD group [(44.00±16.90)vs (19.63±4.41) days, P=0.002]. During a mean follow–up period of 22.16 (3-65) months, one case recurred in PostD group while there was no recurrence in PreD group. Conclusions Prenatal diagnosis, MDT consultations and sequential interventions may be adopted for reducing perioperative complications, shortening disease course and improving the prognosis of neonatal PSC. Key words: Piriform recess; Cyst; Prenatal diagnosis