A novel surgical management of hypopharyngeal branchial anomalies

Givens, Daniel J.; Buchmann, Luke; Park, Albert H.

doi:10.1016/j.ijporl.2015.01.032

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…The average percentage of successful endoscopy was only about 75%, as reviewed by a number of scholars[12]. Several scholars, however, attempted to implement fistulectomy for the third branchial anomalies, with fistulous openings into the pyriform sinus via an anterior neck incision, dissection of the sinus tract, as well as ligation at the opening into the pyriform sinus[1,10,13].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of fistulas arising from the third branchial cleft includes endoscopic cauterization or open cervical fistulectomy[4-8]. A number of scholars have recommended complete excision of the anomaly and selective neck dissection for recurrent cases[4,9,10]. Others have also advocated simple endoscopic cauterization/ablation of the site of the branchial cleft fistula in the pharynx[11,12].…”

Section: Introductionmentioning

confidence: 99%

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Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy

Ding

Zhu

et al. 2019

WJCC

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BACKGROUNDTreatment of fistulas arising from the third branchial cleft includes endoscopic cauterization or open cervical fistulectomy. Both approaches are associated with recurrence rates of 14%-18%, and possibly greater rates when the fistula has been treated operatively beforehand. Treatment of fistulas arising from the third branchial cleft is associated with an inordinate recurrence rate. Recurrence may be multifactorial and related to incomplete resection of all of the anatomical elements of the fistula.AIMTo present a new approach that involves complete resection of the recurrent fistula by a combined therapeutic approach.METHODSHere, 12 adult patients diagnosed with recurrent third branchial cleft fistulas underwent a combined therapy assisted by flexible fiber-optic pharyngoscopy to identify and resect the entry site of the fistula into the pyriform sinus. The fistulous opening into the pyriform sinus was identified by flexible fiber-optic pharyngoscopy. The application of intubation with a guidewire by pharyngoscopy, in addition to the removal of the partial excision of the thyroid cartilage, allowed complete resection of the opening and all parts of the fistula tract.RESULTSAll of the internal openings of the fistulas in the pharynx were found and easily identified by flexible fiber-optic pharyngoscopy. All of the 12 patients underwent complete resection of the recurrent fistula by the combined therapeutic approach. There were no postoperative complications such as parapharyngeal abscess or wound infection, injury or dysfunction of the recurrent laryngeal or superior laryngeal nerves. The pharyngeal edema had degraded, and the pharyngeal wound healed postoperatively within 1 wk. Laryngeal endoscopy and voice analysis were performed on the 14th d post-operatively. Vocal cord movements did not change. The characters of voice for jitter, shimmer, and normalized noise energy were all within normal limits. In addition, no recurrences were observed during the 13-60 mo follow-up period.CONCLUSIONIt can be concluded that the proposed combined therapy is associated with excellent results, minimal morbidity, and no recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy

Ding

Zhu

et al. 2019

WJCC

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“…El grupo de Givens et al 9 asocian a esta téc-nica un colgajo de esternotiroideo de base superior, que lo rotan para reforzar el cierre de la apertura en el seno, sin recidivas en este grupo de pacientes.…”

Section: Discussionunclassified

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

et al. 2018

Rev Chil Cir

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Introduction:Pyriform sinus fistula is a rare cervical branchial anomaly derived from the third and fourth branchial arch. Pyriform sinus fistula should be considered in children presenting enlarged neck mass, fistula, abscess, thyroid infection and/or dysphonia. Objective: We here report 4 cases treated in Hospital Clí-nico Universidad de Chile and review of the current literature on pyriform sinus fistula. Discussion: When clinical presentation is compatible with pyriform sinus fistula, endoscopic and imaging techniques are required. Surgical outcomes are better, although endoscopic therapies and combination of both surgery and endoscopy have also reported good outcomes. Conclusion: Diagnosis is made based on signs and symptoms and a high index of clinical suspicion. Open surgery is gold standard, however in pediatric population endoscopic resolution should be considered to reduce the high morbidity of traditional surgery.

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“…El tratamiento quirúrgico abarca desde el drenaje solamente, con tasas de falla cercanas al 100%, a la fistulectomía abierta, con tasas de éxito del 85% que suben al 92% al asociar la hemitiroidectomía ipsilateral 4 . El grupo de Givens et al 9 asocian a esta técnica un colgajo de esternotiroideo de base superior, que lo rotan para reforzar el cierre de la apertura en el seno, sin recidivas en este grupo de pacientes.…”

Section: Discussionunclassified

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

Rappoport

Jentschyk

Gac

et al. 2017

Revista Chilena de Cirugía

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Congenital pyriform sinus fistula. Report of 4 cases and review of the literature Introduction: Pyriform sinus fistula is a rare cervical branchial anomaly derived from the third and fourth branchial arch. Pyriform sinus fistula should be considered in children presenting enlarged neck mass, fistula, abscess, thyroid infection and/or dysphonia. Objective: We here report 4 cases treated in Hospital Clínico Universidad de Chile and review of the current literature on pyriform sinus fistula. Discussion: When clinical presentation is compatible with pyriform sinus fistula, endoscopic and imaging techniques are required. Surgical outcomes are better, although endoscopic therapies and combination of both surgery and endoscopy have also reported good outcomes. Conclusion: Diagnosis is made based on signs and symptoms and a high index of clinical suspicion. Open surgery is gold standard, however in pediatric population endoscopic resolution should be considered to reduce the high morbidity of traditional surgery.

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A novel surgical management of hypopharyngeal branchial anomalies

Cited by 6 publications

References 20 publications

Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy

Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

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