山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (2): 56-62.doi: 10.6040/j.issn.1673-3770.0.2021.580
徐冬娇,田秀芬
XU Dongjiao, TIAN Xiufen
摘要: 目的 探讨儿童先天性梨状窝瘘的诊断、手术适应证及内镜下低温消融术的疗效。 方法 回顾分析郑州大学第一附属医院内镜下低温消融术治疗的232例儿童先天性梨状窝瘘的临床资料。 结果 217例(93.5%)为左侧梨状窝瘘,14例(6.0%)为右侧梨状窝瘘,1例(0.4%)双侧梨状窝瘘。男女比约1.1∶1.0。232 例均行内镜下梨状窝瘘口低温消融术。术后复发17 例(7.3%)、声音嘶哑12例(5.2%),均无呛咳、食管损伤或咽瘘。 结论 内镜下梨状窝瘘口低温消融术治疗先天性梨状窝瘘具有微创、并发症较少、复发率低等优点,是治疗先天性梨状窝瘘的首选手术方案之一。
中图分类号:
| [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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