Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (1): 125-130.doi: 10.6040/j.issn.1673-3770.0.2021.444

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A clinical analysis on children with congenital pyriform sinus fistula treated through microscopic laryngoscopy with CO2 laser cauterization

LONG Ting, LIU Yuwei, WANG Shengcai, ZHANG Jie, LI Yanzhen, ZHANG Xuexi, LIU Qiaoyin, LIU Zhiyong, SUN Nian, NI Xin   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory for Pediatric Diseases of Otorhinolaryngology Head and Neck Surgery, National Center for Children’s Health (NCCH), Beijing 100045, China
  • Published:2022-02-22

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Abstract: Objective The objective of this study is to explore the clinical characteristics of children with congenital pyriform sinus fistula(CPSF). It also aims to standardize its diagnosis and serve as a reference for the treatment of children with CPSF through microscopic laryngoscopy with CO2 laser cauterization. Methods A retrospective, single-center study was conducted by analyzing the clinical data of children diagnosed with CPSF in Beijing Children's Hospital(BCH)from 2014 to 2021. Microscopic laryngoscopy involving CO2 single-laser cauterization was performed on children with CPSF until the internal fistula completely closed after one or two procedures. Results A total of 273 patients(6.28±3.33 years)were enrolled in this study. Preoperative examination showed a positive predictive value(PPV)of 91.2% when ultrasonography was used, and 82.8% when enhanced magnetic resonance imaging(MRI)was used. All patients were treated with a standardized procedure of CO2 laser cauterization in our center, with 173(63.0%)of the patients undergoing only one operation and 61(22.3%)of the patients undergoing two procedures until the internal fistulas completely closed. Multivariate logistic regression analysis showed that a history of open neck surgery was not related to the number of times the procedure was done. In contrast, the age at the first CO2 laser cauterization surgery was an independent risk factor for the number of procedures needed for the internal fistula to close. All patients did not suffer severe postoperative complications. Conclusion Our study revealed that CO2 laser cauterization is a therapeutic strategy that is effective, safe, and has repeatable results. This method can be the preferred treatment for pediatric CPSF.

Key words: Congenital pyriform sinus fistula, Pediatrics, Carbon dioxide laser, Microscopic laryngoscope

CLC Number: 

  • R762
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