Congenital Pyriform Sinus Fistula Research Articles

The clinical value of recurrent laryngeal nerve dissection in the surgical treatment for congenital pyriform sinus fistula

Objective:To explore the clinical value of recurrent laryngeal nerve dissection in the surgical treatment for congenital pyriform sinus fistula（CPSF）. Methods:The clinical data of 42 patients with CPSF were retrospectively analyzed. All patients were diagnosed and treated in the First Affiliated Hospital of Guangdong Pharmaceutical University. Results:During the operation, all patients' recurrent laryngeal nerves were dissected successfully, and fistulas were resected completely,no patients had complication of recurrent laryngeal nerve's damage.There were no recurrence cases during the 13 to 48 months of follow-up. Conclusion:The trend of congenital pyriform sinus fistula is closely related to recurrent laryngeal nerve, it's important to dissect the recurrent laryngeal nerve during the operation for congenital pyriform sinus fistula.

Ultrasonography in Children With Congenital Pyriform Sinus Fistula: Analysis of 31 Cases.

Congenital pyriform sinus fistula (CPSF) is a rare disease that can be easily misdiagnosed. This study investigates the value of ultrasonography in the early diagnosis and treatment of CPSF in children. Clinical features and ultrasonography images of 31 CPSF pediatric patients confirmed by operation were retrospectively analyzed, different sonographic features during the infection period and the quiescence period were summarized and the consistency test of ultrasonic recognition and diagnosis between observers was conducted. In this study, 25 CPSF children had thick-walled cystic masses during the infection period, and cystic masses of 8 cases showed gas echo inside; after the modified valsalva maneuver, gas echo was found in another 5 cases. The detection rate of gas can be enhanced through the modified valsalva maneuver and infants' cry so as to provide an important basis for the diagnosis of pyriform sinus fistula. During the quiescent period of inflammation of 6 cases, fistula can be completely shown, and the wall structure has not been completely destroyed, so that the running position of fistula can be clearly seen. Ultrasonography boasted a good inter-observer consistency in identification and determination (Kappa:0.799-0.857; P<0.001). Ultrasonography could clearly reveal the position and direction of CPSF fistula. Different ultrasonic characteristics in different periods could provide relevant information for the selection of clinical operation timing and evaluate the post-operative effects.

Clinical application of modified fistulectomy in the treatment of congenital pyriform sinus fistula based on segmental anatomy of fistula

Objective:To discuss the clinical application and significance of the modified piriform fossa fistulectomy based on segmental anatomy of fistula. Methods:The clinical data of 84 patients with CPSF treated by modified pyriform sinus fistulectomy were analyzed retrospectively. The modified piriform fossa fistula resection adopts the fistula anterograde anatomy method to fine dissect the fistula. The operation procedure can be summarized into four parts: retrograde anatomy of recurrent laryngeal nerve, anatomy of external branch of superior laryngeal nerve, anterograde anatomy of fistula and partial thyroidectomy. Results:All 84 patients successfully completed the operation and discharged from the hospital. The operation time was（64.6±20.0） min, the intraoperative bleeding was（19.6±13.0） mL, and the average hospital stay was（6.8±1.1） d. Postoperative infection occurred in 1 case（1.19%）, temporary vocal cord paralysis in 1 case（1.19%）, no bleeding, pharyngeal fistula, dysphagia, permanent vocal cord paralysis and choking cough. The incidence of complications was 2.3%（2/84）. No complications such as permanent vocal cord paralysis and hypothyroidism occurred. Follow up for 57-106（Median 74） months showed no recurrence. Conclusion:A modified procedure based on segmental dissection of the fistula not only simplifies the traditional procedure, but also procedures the specific steps to provide a targeted and precise resection, which provides a proven surgical solution for complete eradication of the lesion and significantly reduces complications and recurrence.

Pediatric bronchogenic cysts in the head and neck region: A study of 10 surgical cases and a review of the literature.

To explore the clinical characteristics and surgical treatment of children with bronchogenic cysts (BCs) in the head and neck region. A retrospective study of 10 pediatric patients with BCs in the head and neck region treated in Shanghai Children's Hospital during 2011 to 2022 was performed. Based on their pathological diagnosis, 10 patients with BCs in the head and neck were identified. The most common location was the neck (8 patients, 80%; 2 midline neck, 6 lateral neck), followed by the ventral tip of tongue (1 patient), and the posterior pharyngeal wall (1 patient). Misdiagnosed as lymphangioma in 5 cases, cyst in 3 cases, thyroglossal duct cyst (TGDC) in 2 cases and congenital pyriform sinus fistula (CPSF) in 1 case preoperative. The median follow-up period after surgery was 4.68 (range, 0.67-9.25) years. All 10 patients underwent complete resection without recurrence or other complications. Although extremely rare, BCs should be considered in the differential diagnosis of midline and lateral neck masses or intraoral cysts in children. Surgical excision is recommended in BCs, and the diagnosis is definitively confirmed by histopathology.

LBODP102 A Case of Unexpected Thyroid Storm Due To Acute Suppurative Thyroiditis From Klebsiella Pneumoniae

Abstract Introduction Thyroid storm is a life-threatening endocrinological emergency. It creates a hypermetabolic state caused by excessive release of thyroid hormones, causing adrenergic hyperactivity following a precipitant(s). An uncommon precipitant of thyroid storm is a thyroid abscess. Clinical Case A 48-year-old man with a PMHx of COPD on home oxygen, OSA, HTN, left thyroid lobe nodule and recent treatment for community-acquired pneumonia the prior week presented to the ED with complaints of right neck pain and swelling of 5 days duration. Patient had associated diarrhea, fever, nausea, vomiting and palpitations. VS: Temp 101.9 F, BP 164/120, RR 20 and HR 160. Physical examination revealed a right non-mobile tender neck mass, rales on the lower lobe of the left lung, and drenching sweats. CT of the neck showed a prominent soft tissue mass on the right side of the neck with irregular margins abutting the right thyroid lobe, suggesting possible abscess. A subsequent thyroid US revealed a large heterogeneous nonvascular right thyroid mass measuring approximately 12×7×7 cm. Initial labs: TSH &amp;lt; 0. 005 mU/L (normal range 0.45-5. 0 mU/L), FT4 2.54 mU/L (normal range 0.9 to 2.3 mU/L); TSHrAB, TSI and TPO were negative. Thyroid storm was diagnosed using the Burch Wartofsky score (45 points). He was treated with propythiouracil, hydrocortisone, propranolol and antibiotics. FT4 normalized after 2 days on admission at which time he was taken for surgical drainage of his right thyroid abscess. 80 cc of pus was aspirated and cultured with isolation of Klebsiella Pneumoniae. Blood cultures also revealed K. Pneumoniae. Repeat Thyroid US showed resolution of abscess. Patient remained in hospital for ongoing treatment of his pneumonia. Clinical Lesson: Acute suppurative thyroiditis (AST) is a rare, life-threatening infection of the thyroid gland. Thyroid gland is rich in iodine, blood supply and lymphatics with a thick capsule which is relatively resistant to infection from neighboring sites. AST is more common in women and affects the left lobe of thyroid. Our patient is a man and his thyroid abscess was on the right lobe. The most common route of infection in AST is a congenital pyriform sinus fistula which was ruled out in our patient with direct laryngoscopy. Common presenting symptoms include fever, neck pain, and dysphagia. Pathogens commonly found to cause AST include Streptococcus and Staphylococcus. Our patient presents as an interesting case of AST from K. Pneumoniae with hematogenous spread that precipitated a thyroid storm. Thyroid storm incidence is noted to be &amp;lt;10%; however, to our knowledge AST is a rare cause of thyroid storm resulting from a thyroid abscess. For patients presenting with thyroid storm and a neck abscess, AST should be kept in mind as a possible etiology. Reference: https://www.ncbi. nlm. nih.gov/pmc/articles/PMC5667251, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587896/ Presentation: No date and time listed

Clinical Features and Treatment of Congenital Pyriform Sinus Fistula: Analysis of 12 Cases.

Congenital pyriform sinus fistula (CPSF) is a rare congenital disease derived from the remnants of the third or fourth branchial cleft. To investigate the imaging characteristics, clinical manifestations, surgical methods, complications, and personalized treatment of CPSF. The clinical data of 12 CPSF patients admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Wenzhou Medical University from March 2016 to May 2021 were retrospectively analyzed. Cryogenic plasma radiofrequency ablation, carbon dioxide laser resection, and external cervical excision were selected based on the individual condition, and postoperative complications and efficacy were evaluated. There were 6 men and 6 women. Neck abscess or thyroiditis was considered at the initial diagnosis. In 11 of the cases, the CPSF was on the left side, whereas in the rest one case, it was on the right. A pyriform fossa fistula was observed during hypopharyngeal iodine angiography. Eight patients were treated with endoscopic piriform fossa fistula laser resection, two with cryogenic plasma radiofrequency ablation, and the rest with external cervical fistula resection. There was no evidence of postoperative hoarseness, pharyngeal fistula, dysphagia, and other complications. CPSF is less common in adults than in children. For patients with recurrent neck abscesses, CPSF should be highly suspected, timely angiography should be performed as soon as possible, and care should be taken to avoid missed diagnoses. The primary method for piriform fossa fistula removal is surgical treatment. Finally, tailoring treatment regimens to the patient's condition can significantly improve curative efficacy.

"Massive hemoptysis" and shock after fever and cough

A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.

A preliminary study on low temperature plasma obliteration for pyriform sinus fistula by visual laryngoscope

Objective:To investigate the effect of low-temperature plasma obliteration for pyriform sinus fistula by visual laryngoscope. Methods:The clinical data of 29 cases with congenital pyriform sinus fistula receiving low temperature plasma obliteration by visual laryngoscope during March 2019 to August 2021 was retrospectively analyzed in department of Otolaryngology Head and Neck Surgery of Children's Hospital of Nanjing Medical University. Nineteen cases accepted the pyriform sinus fistula probing + fistula obliteration, 6 cases accepted the pyriform sinus fistula probing + fistula obliteration + neck abscess incision and drainage, and 4 cases with cervical abscess accepted the pyriform sinus fistula probing + fistula obliteration. Results:All cases had no obvious complications. Two cases had vocal cord impairment after operations and recovered after one month. There was no recurrence in 2 to 30 months follow up, with mean 16 months follow up. Conclusion:Low-temperature plasma obliteration of pyriform sinus fistula by visual laryngoscope is a safe and effective surgical method with little trauma and short hospital stay. It could be the first choice for the treatment of pyriform sinus fistula. Incision and drainage of neck abscess and pyriform sinus fistula obliteration could be performed concurrently.

Endoscopic Suture with Chemocauterization: A Novel Treatment of Congenital Pyriform Sinus Fistula

Endoscopic Suture with Chemocauterization: A Novel Treatment of Congenital Pyriform Sinus Fistula

Imaging Findings in Neonates With Congenital Pyriform Sinus Fistula: A Retrospective Study of 45 Cases.

Background: Congenital pyriform sinus fistula (CPSF) is a rare branchial cleft deformity. The characteristics and management of CPSF in neonates are different from those in children or adults, and a comprehensive understanding of the imaging features of neonatal CPSF can facilitate its preoperative diagnosis. Thus, the aim of this study was to summarize the ultrasonography (US) and CT imaging findings of CPSF in neonates.Methods: Forty-five full-term neonates with CPSF, confirmed by pathology after surgical resection from January 2012 to October 2020, were included in this retrospective study. All patients underwent preoperative cervical US and contrast-enhanced CT examinations, and the imaging findings were analyzed.Results: Forty-six cervical cystic masses were found in 45 neonates, including one case with bilateral lesions, three cases with lesions on the right side, and 41 cases on the left side. Both US and CT detected neck abnormality among all cases, while the diagnostic accuracy of US (15/46, 32.6%) was lower than that of CT (42/46, 91.3%). Moreover, CT showed significantly higher detection rates of intralesional air bubbles, involvement of the ipsilateral thyroid, deviation of the airway, and expansion into the mediastinal and retropharyngeal space compared with the US. As the age increased, it was more likely to present some features including the absence of air-containing, thick cyst wall, and poorly defined border (ρ <0.05).Conclusion: CPSF in the neonates showed distinctive imaging findings on contrast-enhanced CT scan, which provides important supplementary information for the diagnosis of CPSF after the initial US examination.

A comparison between endoscopic CO2 laser cauterization and open neck surgery in the treatment of congenital piriform fistula

Objective: To compare the efficacy, advantages and disadvantages of endoscopic CO2 laser cauterization (ECLC) and open neck surgery in the treatment of congenital pyriform sinus fistula (CPSF). Methods: From September 2014 to March 2017, 80 cases with confirmed diagnosis of CPSF received initial treatment at Guangdong Provincial People's Hospital were prospectively analyzed, including 34 males and 46 females, aged 18 to 672 (194.17±141.18) months. They were consecutively divided into endoscopic group and open-surgery group, with 40 cases in each group. Both groups of patients received surgical treatment under general anesthesia. The endoscopic group was treated by endoscopic CO2 laser cauterization, and the open-surgery group underwent the following surgery: first, we performed suspension laryngoscopy examination to confirm the presence of fistula in the bottom of the piriform fossa, then open-neck resection of congenital piriform sinus fistula with recurrent laryngeal nerve and/or lateral branch of superior laryngeal nerve anatomy plus partial thyroidectomy were performed. The data between the two groups were compared, including the operative time, intraoperative blood loss, postoperative pain, average length of stay, neck cosmetic scores, complications and cure rates. All patients were followed up in outpatient clinics. Statistical analysis was performed using SPSS 20.0 software. P<0.05 indicates that the difference is statistically significant. Results: All patients were successfully completed the operation. The operative time, intraoperative blood loss, postoperative pain and average length of hospital stay in the endoscopic group were significantly less than those in the open group [(27.4±5.5) min to (105.8±52.5) min, (0.6±0.5) ml to (33.6±41.5) ml, (1.7±0.9) points to (4.6±0.7) points, (5.9±2.9)d to(8.9±3.3)d, t values were-9.400, -5.031, -16.199, -4.293, P values were all<0.01]; The neck cosmetic score in the endoscopy group was significantly greater than that of the open group [(9.9±0.4) against (5.8±0.9) points, t=25.847, P<0.01]. Compared with the open group (15.0%, 6/40), the complication rate of the endoscopic group (7.5%, 3/40) was not statistically significant (χ²=0.50, P>0.05). Three months after the first treatment, the cure rate in the endoscopic group (82.5%, 33/40) was significantly lower than that in the open-neck group (100.0%, 40/40), χ²=5.64, P<0.05. The follow-up time was 12 months after the last treatment. Eighty cases were followed up and none was lost to follow-up. During the follow-up period, the cure rate of the endoscopy group (97.5%, 39/40) was compared with that of the open group (100.0%, 40/40), and the difference was not statistically significant. Conclusions: In the treatment of CPSF, the two-surgical method each has their advantages. Compared with open-neck surgery, ECLC is simpler, repeatable. ECLC has shorter time in operation and hospital stay, less complications, and less postoperative pain and more precise cosmetic results. It could be preferred for the initial treatment of CPSF and relapsed cases after cauterization. But subject to relatively low cure rate of one-time cauterization and uncertain long-term efficacy, it cannot completely replace the open-neck surgery at present.

Endoscopic coblation treatment for congenital pyriform sinus fistula in children.

Congenital pyriform sinus fistula (CPSF) is a very rare branchial apparatus malformation. Traditional open surgery for fistulectomy might fail to excise the lesion completely, leading to continual recurrence. Herein, we report our experience of endoscopic coblation technique for treatment of CPSF in children.To observe the clinical efficacy of endoscopic coblation treatment of CPSF in children, especially for those in acute infection stage.Retrospective case series with 54 patients (including 20 cases in acute infection stage and 34 cases in non infection stage) who were diagnosed with CPSF between October 2017 to November 2019, all patients were treated with endoscopic coblation to close the piriform fossa fistula, neck abscess incision and drainage performed simultaneously for acute infection stage cases. Data collected including age of diagnosis, presenting symptoms, diagnostic methods, prior and subsequent treatments, length of hospitalization, and recurrence were analyzed.Of the 20 cases in acute infection stage, there were 3 children with transient vocal cord paresis all of which resolved with 1 month. Four children of the 34 cases in non infection stage appeared reddish swelling of the neck on the 4th, 5th, 6th, and 7th days after coblation and then underwent abscess incision and drainage. All cases experienced no recurrence, vocal cord paralysis, pharyngeal fistula and massive hemorrhage after their first endoscopic coblation of the sinus tract in the follow up of 3 to 28 months.Endoscopic coblation is an effective and safe approach for children with CPSF, neck abscess incision and drainage could be performed simultaneously in acute infection stage. We advocate using this minimally invasive technique as first line of treatment for CPSF.

Clinical analysis of treatment and postoperative efficacy in neonatal congenital pyriform sinus fistula

Objective:To discuss the diagnosis and treatment of congenital pyriform sinus fistula（CPSF） in newborn. Methods:Clinical data of 5 patients with CPSF innewborn were reviewed and the clinical symptoms, auxiliary examinations, surgical methods were analyzed after the operation, patients were followed up closely at different stages. Results:All the 5 neonates successfully completed the surgery without pharyngeal fistula, dysphagia, perifistula and distal fistula infection. Follow-up survey ranged from 3 months to 2 years and no one recurred. Conclusion:Neonatal CPSF is a rare disease with a short course of disease and rapid progression. In severe cases, it may threaten life and should be treated in time.

Application of Gastroscopy in the Diagnosis of Congenital Pyriform Sinus Fistula in Children.

Objective: The aim of this study was to explore the diagnostic value of gastroscopy under local anesthesia for congenital pyriform sinus fistula (CPSF).Methods: This research was a diagnostic study. Patients received gastroscopy under local anesthesia to diagnose CPSF, and suspension laryngoscopy under general anesthesia was performed 2 days after gastroscopy. Various conditions of the internal opening of CPSF were then recorded. Patients were grouped according to lesion sides, age, time after the inflammation subsided, and history of previous surgery. The sensitivity, specificity, area under the receiver operating characteristic curve (AUC), accuracy, and positive and negative predictive values of gastroscopy were compared between the groups.Results: A total of 48 patients were recruited in this study, and no patients had severe gastroscopy-related complications. The diagnostic values of gastroscopy in 41 cases (85.4%) were consistent with suspension laryngoscopy. The sensitivity of gastroscopy was 86.4%, the specificity was 75%, the AUC was 0.807, the positive prediction rate was 97.4%, the negative prediction rate was 33.3%, the accuracy rate was 85.4%, and the diagnostic odds ratio (DOR) was 2.1. The kappa consistency test results had statistical significance (P = 0.0026, kappa = 0.3913). The diagnostic value of gastroscopy was better for the patients with inflammation subsiding for more than 4 weeks (P < 0.0001).Conclusion: Gastroscopy under local anesthesia is a safe, effective, reliable and novel diagnostic method for CPSF, and it is especially recommended as a diagnostic method for the patients with inflammation subsiding for more than 4 weeks.

Outcomes of endoscopic chemo- and laser-cauterizations and open fistulectomy for pyriform sinus fistula

BackgroundAcute suppurative thyroiditis through the congenital pyriform sinus fistula (PSF) often recurs if the fistula is not resected. Although endoscopic chemo-cauterization (ECC) to obliterate the orifice of the fistula is less invasive than open fistulectomy, it may require repeated treatments. We recently adopted an endoscopic diode laser-cauterization (ELC) system with the intention of improving treatment outcomes in PSF. Here, we describe ELC and compare the outcomes of these three modalities.MethodsWe evaluated 83 patients with PSF who underwent treatment between 2007 and 2018 at Kuma Hospital, a tertiary thyroid treatment hospital. ECC and ELC were implemented in 2007 and 2015, respectively. Patients who were ineligible for the endoscopic procedures underwent open fistulectomy. Barium swallow studies and computed tomography scan under a trumpet maneuver were performed after treatment to evaluate obliteration or removal of the fistula.ResultsIn total, 70 of the 81 (86%) patients who underwent barium swallow studies after the first treatment achieved obliteration or removal of the fistula. The success rates for open fistulectomy, ECC, and ELC were 100% (9/9), 83% (49/59), and 100% (13/13), respectively. ECC and ELC had significantly shorter operative times and lower blood loss than open fistulectomy. Insufficient opening of the mouth was the major reason for converting endoscopic procedures to open fistulectomy.ConclusionsELC may yield superior outcomes and is therefore the optimal treatment modality for PSF. However, it is still associated with certain limitations. Thus, treatment selection remains dependent on the shape and size of the PSF and the mouth opening of the individual patient.Graphical

Clinical practice guidelines for the diagnosis and management of congenital pyriform sinus fistula in children

Clinical practice guidelines for the diagnosis and management of congenital pyriform sinus fistula in children

MRI in Children With Pyriform Sinus Fistula

A variety of imaging modalities have been described for the diagnosis of congenital pyriform sinus fistula (CPSF). To date, there have been few MRI reports. To evaluate MRI findings of CPSF and interobserver reliability. Retrospective. In all, 115 patients aged 23 days to 15.4 years at operation. 3.0T/axial T1 -weighted image (T1 WI)-SPIR, axial T2 WI, axial T2 WI-STIR, coronal T2 WI-SPIR, diffusion-weighted imaging (DWI), axial and coronal gadolinium-enhanced T1 WI-SPIR. For each patient, the medical records, including demographics, clinical manifestations, and MRI findings were reviewed. All the MRI studies were interpreted by three radiologists independently. Kendall's W test was made to determine the interobserver reliability of three reviewers for MRI findings. CPSF occurred on the left side in 104 (90.4%) patients and on the right side in 11 (9.6%) patients. The male-to-female ratio was 59:56. The age at first episode varied from birth to 12.3 years. There was one neonate patient, who presented with a unilocular cystic mass in the left neck. A tunnel-like lesion between the pyriform fossa and the upper pole of the thyroid gland, T2 high signal behind the cricothyroid joint, thyroid gland involvement, deep neck abscesses or masses were noted in 46 (40%), 93 (80.9%), 96 (83.5%), and 36 (31.3%) patients, respectively. There was excellent interobserver reliability for all the MRI findings, ranging from 0.84 to 1.00. The sinus tract presenting with a tunnel-like lesion goes behind the cricothyroid joint in most cases. For patients presenting with acute suppurative thyroiditis (AST) or neck infection with thyroid gland involvement, the presence of T2 high signal behind the cricothyroid joint highly suggests the diagnosis of CPSF. MRI is a reliable method for the diagnosis of CPSF. 4 TECHNICAL EFFICACY STAGE: 2.

The treatment of congenital pyriform sinus fistula: a single-center experience.

Congenital pyriform sinus fistula (CPSF) often presents diagnosis and treatment challenges. This study aimed to explore the treatment principles and to evaluate the effectiveness of the hypothermia plasma cauterization with suspension laryngoscopy for CPSF. The medical records of 56 patients with CPSF from January 2000 to December 2019 were retrospectively reviewed. Of the 56 cases, the lesions were predominantly located on the left side (95%), and the accuracy of the first diagnosis was 30%. Ultrasound showed an abnormal rate of 86%, while CT or MRI displayed an abnormal anatomic lesion of 92%. The 3D visual reconstruction enabled the analysis of morphological characteristics of CPSF. The positive predictive value of barium esophagography was 89%, whereas the positive rate of the internal opening in CPSF under local anesthesia laryngoscopy was 33%. Nine cases of sinus type underwent open resection, and the recurrence rate was 33%. Interestingly, ten patients with sinus type underwent hypothermia plasma cauterization with suspension laryngoscopy, leading to a success rate of 100% without apparent complications. Hypothermia plasma cauterization with suspension laryngoscopy alongside 3D imaging is both minimally invasive and repeatable with neglectable complications, which has the potential to serve as the first-line treatment for CPSF in the future.

Clinical efficacy of low-temperature radiofrequency ablaion assisted by endoscopy for the treatment of congenital pyriform sinus fistula in infants

Objective:To discuss the clinical efficacy of low-temperature radiofrequency ablaion assisted by endoscopy for the treatment of congenital pyriform sinus fistula in infants. Method:Clinical data of 15 patients with CPSF received the low-temperature radiofrequency ablaion assisted by endoscopy under laryngoscope were reviewed. After the operation, patients were followed up closely at different stages. All patients underwent neck color doppler ultrasound and electronic laryngoscopy, and the results were analyzed. Result:The operation of 15 children was successfully completed without pharyngeal fistula, dysphagia, perifistula and distal fistula infection. Followup survey ranged from 3 months to 3 years and no one recurred. Conclusion:Low-temperature radiofrequency ablaion assisted by endoscopy is a promising method for the CPSF with less trauma, less haemorrhage and good vision. It is safe and effective for the treatment of CPSF in infants and children, and is worthy of clinical promotion.

Preoperative identification of the congenital pyriform sinus fistula with the modified Killian’s method: A case report

Preoperative identification of the congenital pyriform sinus fistula with the modified Killian’s method: A case report