Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (2): 56-62.doi: 10.6040/j.issn.1673-3770.0.2021.580

• 论著 • Previous Articles    

232 children with congenital pyriform sinus fistula treated by endoscopic radiofrequency ablation

XU Dongjiao, TIAN Xiufen   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
  • Published:2023-03-30

Abstract: Objective To evaluate the diagnosis, indications, and surgical outcomes of congenital pyriform sinus fistula(CPSF)treated by endoscopic radiofrequency ablation. Methods The data of 232 children with CPSF treated at the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. Results The lesions were predominantly on the left side(217/232, 93.5%), 14 cases were on the right side, and only 1 case was bilateral. The ratio of males to females was about 1.1∶0. Of all 232 cases who underwent endoscopic radiofrequency ablation, 17 cases(7.3%)had recurrence. Postoperative hoarseness occurred in 12 cases, and disappeared within 0.5-2.0 months and there was no irritating cough, esophageal injury, or pharyngeal fistula post operation. Conclusion Endoscopic radiofrequency ablation is one of the best choices for the treatment of CPSF, with advantages such as minimal invasiveness, few complications, and a low recurrence rate.

Key words: Congenital pyriform sinus fistula, Branchial fissure deformity, Radiofrequency ablation, Hoarseness, Children

CLC Number: 

  • R726.5
[1] Pereira KD, Losh GG, Oliver D, et al. Management of anomalies of the third and fourth branchial pouches[J]. Int J Pediatr Otorhinolaryngol, 2004, 68(1): 43-50. doi:10.1016/j.ijporl.2003.09.004
[2] Leboulanger N, Ruellan K, Nevoux J, et al. Neonatal vs delayed-onset fourth branchial pouch anomalies: therapeutic implications[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(9): 885-890. doi:10.1001/archoto.2010.148
[3] Mandell DL. Head and neck anomalies related to the branchial apparatus[J]. Otolaryngol Clin North Am, 2000, 33(6): 1309-1332. doi:10.1016/s0030-6665(05)70283-8
[4] Nicoucar K, Giger R, Jaecklin T, et al. Management of congenital third branchial arch anomalies: a systematic review[J]. Otolaryngol Head Neck Surg, 2010, 142(1): 21-28.e2. doi:10.1016/j.otohns.2009.09.001
[5] Nicoucar K, Giger R, Pope HG Jr, et al. Management of congenital fourth branchial arch anomalies: a review and analysis of published cases[J]. J Pediatr Surg, 2009, 44(7): 1432-1439. doi:10.1016/j.jpedsurg.2008.12.001
[6] 李晓艳, 刘大波, 陈良嗣, 等. 儿童先天性梨状窝瘘诊断与治疗临床实践指南[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(12): 1060-1064. doi:10.13201/j.issn.2096-7993.2020.12.002 LI Xiaoyan, Liu Dabo, Chen Liangsi, et al. Clinical practice guidelines for the diagnosis and management of congenital pyriform sinus fistula in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(12): 1060-1064. doi:10.13201/j.issn.2096-7993.2020.12.002
[7] Falhammar H, Wallin G, Calissendorff J. Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes[J]. BMC Endocr Disord, 2019, 19(1): 130. doi:10.1186/s12902-019-0458-0
[8] Xia LG, Lin ZX, Lin XK, et al. The treatment of congenital pyriform sinus fistula: a single-center experience[J]. Pediatr Surg Int, 2020, 36(7): 779-788. doi:10.1007/s00383-020-04676-2
[9] Prasad SC, Azeez A, Thada ND, et al. Branchial anomalies: diagnosis and management[J]. Int J Otolaryngol, 2014, 2014: 237015. doi:10.1155/2014/237015
[10] 窦倩雯, 田秀芬. 低温等离子射频消融治疗216例先天性梨状窝瘘的临床分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 43-49. doi:10.6040/j.issn.1673-3770.1.2020.092 DOU Qianwen, TIAN Xiufen. Clinical analysis of 216 cases of congenital pyriform sinus fistula treated by radiofrequency ablation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 43-49. doi:10.6040/j.issn.1673-3770.1.2020.092
[11] Abbas PI, Roehm CE, Friedman EM, et al. Successful endoscopic ablation of a pyriform sinus fistula in a child: case report and literature review[J]. Pediatr Surg Int, 2016, 32(6): 623-627. doi:10.1007/s00383-016-3868-3
[12] Huang YC, Peng SSF, Hsu WC. KTP laser assisted endoscopic tissue fibrin glue biocauterization for congenital pyriform sinus fistula in children[J]. Int J Pediatr Otorhinolaryngol, 2016, 85: 115-119. doi:10.1016/j.ijporl.2016.03.028
[13] Li Y, Lyu KX, Wen YH, et al. Third or fourth branchial pouch sinus lesions: a case series and management algorithm[J]. J Otolaryngol Head Neck Surg, 2019, 48(1): 61. doi:10.1186/s40463-019-0371-6
[14] Teng YS, Huang SL, Chen GW, et al. Congenital pyriform sinus fistula presenting as a neck abscess in a newborn[J]. Medicine, 2019, 98(44): e17784. doi:10.1097/md.0000000000017784
[15] Sheng QF, Lv ZB, Xiao XM, et al. Diagnosis and management of pyriform sinus fistula: experience in 48 cases[J]. J Pediatr Surg, 2014, 49(3): 455-459. doi:10.1016/j.jpedsurg.2013.07.008
[16] Pan J, Zou Y, Li L, et al. Clinical and imaging differences between neonates and children with pyriform sinus fistula: which is preferred for diagnosis, computed tomography, or Barium esophagography? [J]. J Pediatr Surg, 2017, 52(11): 1878-1881. doi:10.1016/j.jpedsurg.2017.08.006
[17] Zhu TT, Huang Y. Contrast-enhanced ultrasound diagnosed a pyriform sinus fistula that failed to be diagnosed by a Barium swallow examination: case report and review of choices for the imaging examination[J]. J Ultrasound Med, 2020, 39(8): 1669-1673. doi:10.1002/jum.15239
[18] Chauhan NS, Sharma YP, Bhagra T, et al. Branchial fistula arising from pyriform Fossa: CT diagnosis of a case and discussion of radiological features[J]. Clin Imaging, 2012, 36(5): 591-594. doi:10.1016/j.clinimag.2012.01.032
[19] 鲍俊涛, 孙占伟, 张书峰, 等. 个体化术式选择治疗儿童梨状窝瘘的效果分析[J]. 中华实用儿科临床杂志, 2021, 36(11): 836-839. doi:10.3760/cma.j.cn101070-20200224-00229 BAO Juntao, SUN Zhanwei, ZHANG Shufeng, et al. Analysis on the effects of individualized surgical method for treating pyriform sinus fistula in children[J]. Chinese Journal of Applied Clinical Pediatrics, 2021, 36(11): 836-839. doi:10.3760/cma.j.cn101070-20200224-00229
[20] Jordan JA, Graves JE, Manning SC, et al. Endoscopic cauterization for treatment of fourth branchial cleft sinuses[J]. Arch Otolaryngol Head Neck Surg, 1998, 124(9): 1021-1024. doi:10.1001/archotol.124.9.1021
[21] Watson GJ, Nichani JR, Rothera MP, et al. Case series: Endoscopic management of fourth branchial arch anomalies[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(5): 766-769. doi:10.1016/j.ijporl.2013.02.007
[22] Pereira KD, Smith SL. Endoscopic chemical cautery of piriform sinus tracts: a safe new technique[J]. Int J Pediatr Otorhinolaryngol, 2008, 72(2): 185-188. doi:10.1016/j.ijporl.2007.10.007
[23] Stenquist M, Juhlin C, Aström G, et al. Fourth branchial pouch sinus with recurrent deep cervical abscesses successfully treated with trichloroacetic acid cauterization[J]. Acta Otolaryngol, 2003, 123(7): 879-882. doi:10.1080/00016489.2003.11876967
[24] Neff L, Kirse D, Pranikoff T. An unusual presentation of a fourth pharyngeal arch(branchial cleft)sinus[J]. J Pediatr Surg, 2009, 44(3): 626-629. doi:10.1016/j.jpedsurg.2008.10.060
[25] Cha W, Cho SW, Hah JH, et al. Chemocauterization of the internal opening with trichloroacetic acid as first-line treatment for pyriform sinus fistula[J]. Head Neck, 2013, 35(3): 431-435. doi:10.1002/hed.22998
[26] 李万鹏, 浦诗磊, 刘晓君, 等. 低温等离子射频消融治疗37例梨状窝瘘的临床分析[J]. 中国眼耳鼻喉科杂志, 2019, 19(6): 395-399. doi:10.14166/j.issn.1671-2420.2019.06.009 LI Wanpeng, PU Shilei, LIU Xiaojun, et al. Clinical analysis of radiofrequency ablation in the treatment of piriform Fossa fistula in 37 cases[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2019, 19(6): 395-399. doi:10.14166/j.issn.1671-2420.2019.06.009
[27] Zhang PJ, Tian XF. Recurrent neck lesions secondary to pyriform sinus fistula[J]. Eur Arch Oto Rhino Laryngol, 2016, 273(3): 735-739. doi:10.1007/s00405-015-3572-2
[28] Josephson GD, Black K. A review over the past 15 years of the management of the internal piriform apex sinus tract of a branchial pouch anomaly and case description[J]. Ann Otol Rhinol Laryngol, 2015, 124(12): 947-952. doi:10.1177/0003489415593554
[29] Derks LSM, Veenstra HJ, Oomen KPQ, et al. Surgery versus endoscopic cauterization in patients with third or fourth branchial pouch sinuses: a systematic review[J]. Laryngoscope, 2016, 126(1): 212-217. doi:10.1002/lary.25321
[30] 董锦锦, 田秀芬. 先天性梨状窝瘘的诊断与治疗经验探讨[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(6): 444-447. doi:10.3760/cma.j.issn.1673-0860.2018.06.011 DONG Jinjin, TIAN Xiufen. Experience of diagnosis and treatment for congenital pyriform sinus fistula[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2018, 53(6): 444-447. doi:10.3760/cma.j.issn.1673-0860.2018.06.011
[31] 龙婷, 刘雨薇, 王生才, 等. 内镜CO2激光烧灼术治疗273例儿童先天性梨状窝瘘的临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 125-130. doi:10.6040/j.issn.1673-3770.0.2021.444 LONG Ting, LIU Yuwei, WANG Shengcai, et al. A clinical analysis on children with congenital pyriform sinus fistula treated through microscopic laryngos-copy with CO2 laser cauterization[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 125-130. doi:10.6040/j.issn.1673-3770.0.2021.444
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