Abstract: Objective To summarize the clinical characteristics, diagnosis and treatment of pyriform sinus fistula in neonates. Methods The clinical manifestation, auxiliary examination, treatment and prognosis of 3 cases of pyriform sinus fistula in our department were analyzed retrospectively between January 2018 and June 2020. Results 3 cases of pyriform sinus fistula were reported, there were 2 boys and 1 girl. One male child was found to have neck tumor 10 days after birth, and the other two cases were found in prenatal examination; 3 cases of pyriform sinus fistula were all on the left side; 3 cases of neck B-ultrasound showed cystic mass in the neck, with thick wall, punctate gas echo in the cavity, and enhanced CT showed gas-liquid level in the cavity. All the 3 cases were treated by operation. Two of them were founded the fistula after removing the tumor and ligated it smoothly. The internal fistula of pyriform sinus was not treated specially. The other one was cut and drained and then cauterized by laser under endoscope. The patients were followed up for 5 months to 2 years after surgery. No recurrence or repeated infection was found. Conclusion The neonatal pyriform sinus fistula usually starts with painless neck mass or is founded in prenatal examination. B-ultrasound and CT examination of the neck showed that the masses were often seen Gas shadow, progressive enlargement of tumor after birth, At this time, we need to highly suspect the pyriform sinus fistula. Surgical treatment is the fundamental method to eliminate the pyriform sinus fistula. No recurrence was found in the laser cauterization of the internal fistula and high ligation of the fistula after removal of the neck mass.

Key words: Pyriform sinus fistula, Newborns, Neck mass, Gas shadow