Successful endoscopic ablation of a pyriform sinus fistula in a child: case report and literature review

Abbas, Paulette I.; Roehm, Corrie E.; Friedman, Ellen M.; Athanassaki, Ioanna; Kim, Eugene; Brandt, Mary L.; Wesson, David E.; López, Mónica E.

doi:10.1007/s00383-016-3868-3

Cited by 17 publications

(18 citation statements)

References 19 publications

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“…Based on these anatomic course and fusion, clinical manifestations of recurrent deep neck infections or suppurative thyroiditis, especially occurring in the left side, CSPF should be considered. [ 2 , 4 ]…”

Section: Discussionmentioning

confidence: 99%

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Chen

et al. 2021

Medicine

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Congenital pyriform sinus fistula (CPSF) is a very rare branchial apparatus malformation. Traditional open surgery for fistulectomy might fail to excise the lesion completely, leading to continual recurrence. Herein, we report our experience of endoscopic coblation technique for treatment of CPSF in children. To observe the clinical efficacy of endoscopic coblation treatment of CPSF in children, especially for those in acute infection stage. Retrospective case series with 54 patients (including 20 cases in acute infection stage and 34 cases in non infection stage) who were diagnosed with CPSF between October 2017 to November 2019, all patients were treated with endoscopic coblation to close the piriform fossa fistula, neck abscess incision and drainage performed simultaneously for acute infection stage cases. Data collected including age of diagnosis, presenting symptoms, diagnostic methods, prior and subsequent treatments, length of hospitalization, and recurrence were analyzed. Of the 20 cases in acute infection stage, there were 3 children with transient vocal cord paresis all of which resolved with 1 month. Four children of the 34 cases in non infection stage appeared reddish swelling of the neck on the 4th, 5th, 6th, and 7th days after coblation and then underwent abscess incision and drainage. All cases experienced no recurrence, vocal cord paralysis, pharyngeal fistula and massive hemorrhage after their first endoscopic coblation of the sinus tract in the follow up of 3 to 28 months. Endoscopic coblation is an effective and safe approach for children with CPSF, neck abscess incision and drainage could be performed simultaneously in acute infection stage. We advocate using this minimally invasive technique as first line of treatment for CPSF.

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Section: Discussionmentioning

confidence: 99%

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Chen

et al. 2021

Medicine

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“… 7 In the past, open surgery of the fistula and related hemithyroidectomy were performed, but recently, there have been reports of endoscopically cauterizing the fistula using a laser. 8 There are also reports showing the effectiveness of endoscopic coblation as a first‐line treatment for PSF. 9 There is still a risk of fistula recurrence if only its surface is cauterized.…”

Section: Discussionmentioning

confidence: 99%

A laser‐assisted endoscopic approach to pyriform sinus fistula via fibrin glue cauterization

Momii

Kawano

Takakura

et al. 2022

Clinical Case Reports

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In the past, the general treatment method for pyriform sinus fistula was its removal by open surgery; however, in recent years, endoscopic surgery has become more common. We report two cases where laser surgery was performed using an endoscope and recurrence was prevented using fibrin glue. Both cases involved 3‐year‐old girls who underwent laser ablation of a pyriform sinus fistula under an endoscope, after which the site was closed with fibrin glue. No recurrence was observed in either case, and the postoperative course was uneventful. This approach is presented as a non‐invasive and effective treatment for pyriform sinus fistula.

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“…After 4 to 6 weeks of inflammation control, surgical intervention was the most significant way to avoid recurrence. In recent years, several reports have described endoscopic minimally invasive technology concomitant with incision and drainage for the treatment of PSF during the period of active inflammation [13][14][15][16][17] (Table 4). Abbas et al 17 managed with concurrent endoscopic ablation and incision and drainage for a 12-year-old girl with a history of recurrent thyroid abscesses secondary to PSF.…”

Section: Discussionmentioning

confidence: 99%

Open Surgical Excision Versus Endoscopic Radiofrequency Ablation for Piriform Fossa Fistula

et al. 2020

Ear Nose Throat J

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Objectives: The purpose of this study is to explore the curative effect of open surgical excision and endoscopic radiofrequency ablation (RA) in the treatment of piriform fossa fistula (PSF). Methods: Retrospective study of 80 cases of PSF in the Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, from June 2009 to June 2017. Results: In this series, there were 43 males and 37 females, and the mean age was 5.2 years (17 days to 12 years). Surgical excision was performed for 62 patients. Radiofrequency ablation was performed for 18 patients. Six cases of postoperative temporary hoarseness occurred, and the hoarseness rates were not significantly different between the excision and RA groups (6.4% vs 11.1%, respectively, P = .88). Two cases of temporary neck abscess occurred in the RA group. After the mean follow-up period of 3.1 years (1-8 years), no recurrence was found between the excision and RA groups. Conclusions: The curative effect of excision and RA for PSF is not significantly different; each of the 2 methods has its advantages and disadvantages. However, RA for PSF has the merit of being minimally invasive, easy to operate, and safe; this procedure seems to be more suitable in the clinic.

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Successful endoscopic ablation of a pyriform sinus fistula in a child: case report and literature review

Cited by 17 publications

References 19 publications

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

A laser‐assisted endoscopic approach to pyriform sinus fistula via fibrin glue cauterization

Open Surgical Excision Versus Endoscopic Radiofrequency Ablation for Piriform Fossa Fistula

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