Diagnosis and management of pyriform sinus fistula: Experience in 48 cases

Sheng, Qingfeng; Lv, Zhibao; Xiao, Xianmin; Zheng, Shan; Huang, Yimin; Xiong, Hui; Li, Hui; Wu, Yibo; Dong, Kuiran; Liu, Jiangbin

doi:10.1016/j.jpedsurg.2013.07.008

Cited by 47 publications

(47 citation statements)

References 25 publications

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“…mostrar en forma tridimensional aire en el posible trayecto fistuloso, extensión del absceso, pérdida de la rápida atenuación del contraste del tiroides, obliteración del seno piriforme, compromiso mediastínico, etc. 6 . Es importante resaltar que esta técnica se enriquece del uso de medio de contraste intravenoso y oral, logrando con este último una fistulografía tridimensional cuando se contrasta la fístula, alcanzado un VPP de hasta un 88% 5 .…”

Section: Discussionunclassified

“…Es importante resaltar que esta técnica se enriquece del uso de medio de contraste intravenoso y oral, logrando con este último una fistulografía tridimensional cuando se contrasta la fístula, alcanzado un VPP de hasta un 88% 5 . Hay otros que prefieren el uso de resonancia magnética, la que podría discriminar mejor en partes blandas la zona de la fístula, absceso, etc., pero con un VPP inferior del orden del 63% 6 .…”

Section: Discussionunclassified

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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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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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“…A definitive diagnosis requires detection of the fistula, which originates from the pyriform sinus and extends to the cystic lesion [5][6][7][8]. Sonography has been reported to be a good modality for detection of fistulas [9,10], but there have been no reports of neonatal cases in which sonographic findings were important for detection of a fistula.…”

Section: Discussionmentioning

confidence: 99%

“…A definitive diagnosis requires detection of the fistula, which originates from the pyriform sinus and extends to the cystic lesion [5][6][7][8]. Various modalities, including sonography, barium esophagography, computed tomography (CT), magnetic resonance imaging (MRI), and direct infusion of contrast agent into the cystic lesion, can be used to detect fistulas [5,7,9,10]. Sonography has been reported to be useful for detecting fistulas, but there have been no reports of neonatal cases in which sonography was able to detect fistulas that were not detected by other modalities.…”

Section: Introductionmentioning

confidence: 99%

Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

et al. 2015

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Pyriform sinus fistulas are an unusual cause of neck cystic lesions in neonates. A definitive diagnosis requires detection of the fistula, which originates from the pyriform sinus and extends to the cystic lesion. Sonography has been reported to be useful for detecting fistulas. However, there have been no reports of neonatal cases in which sonography could detect fistulas not detected by other modalities, such as barium esophagography, computed tomography (CT), or magnetic resonance imaging (MRI). We describe five neonatal patients with pyriform sinus fistula-appearing cervical cystic lesions. All patients were examined by sonography; of these, three patients were also examined by barium esophagography, two by CT, and one by MRI. The fistula was detected by sonography but not CT in one patient and by barium esophagography but not MRI in one. Two patients whose fistulas were detected by sonography had an oval-shaped and relatively small cystic lesion. One patient whose fistula could be detected only by barium esophagography had a relatively large cystic lesion. In two patients, whose fistulas were not detected by sonography or barium esophagography, sonography revealed air bubbles within the cystic lesions, and a pyriform sinus fistula was suspected. Without requiring ionizing radiation, sonography was thus useful in diagnosing pyriform sinus fistula-appearing cervical cystic lesions in neonatal cases. On the other hand, in two patients whose fistulas were not detected by sonography, the shape of the cystic lesion was polygonal or multicystic. In two of three patients with infectious signs, a fistula could not be detected. The shape and size of the cystic lesion and the presence of infectious signs may be important factors for detecting fistulas.

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“…Furthermore, the normal mucosal layers cannot be sutured during open neck surgery, which leads to a high risk of recurrence and cosmetic problems due to the neck incision. In addition, the surgical procedure carries a high risk of complications, such as injury to the recurrent laryngeal nerve [8,9]. Thus, appropriate technical support is required to ensure the safety of the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

Submucosal Abscess of the Esophagus Caused by Piriform Sinus Fistula Treated with Transoral Video Laryngoscopic Surgery

Koyama

Fujiwara

Morisaki

et al. 2016

ORL

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Piriform sinus fistula (PSF) is a rare branchial anomaly that causes repetitive acute suppurative thyroiditis or deep neck abscess. The definitive treatment of PSF is open neck surgery. However, such surgery has a cosmetic problem and a high risk of recurrence. Furthermore, identifying the fistula is difficult due to previous repetitive infections. We report a case of esophageal submucosal abscess caused by PSF treated with endoscopic mucosal incision. The patient underwent transoral video laryngoscopic surgery (TOVS), and endoscopy as well as fluoroscopy revealed complete closure of PSF without any complication. TOVS is a novel surgical technique for the definitive treatment of PSF with esophageal submucosal abscess.

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Diagnosis and management of pyriform sinus fistula: Experience in 48 cases

Cited by 47 publications

References 25 publications

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

Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

Submucosal Abscess of the Esophagus Caused by Piriform Sinus Fistula Treated with Transoral Video Laryngoscopic Surgery

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