Endoscopic electrocauterization of pyriform sinus fistula

Ishinaga, Hajime; Kobayashi, Masayoshi; Qtsu, Kazuya; Nishida, Kohei; Sakaida, Hiroshi; Kitano, Masako; Nakamura, Satoshi; Chiyonobu, Kazuki; Takeuchi, Kazuhiko

doi:10.1007/s00405-017-4713-6

Cited by 16 publications

(24 citation statements)

References 11 publications

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“…CPSF is a rare anomaly from failure of the third and fourth brachial clefts to involute and few studies in the literature have more than a handful of patients. [ 2 , 3 ] There is no significant difference between males and females and 90% of cases occur on the left side. [ 14 ] The asymmetric development of branchial apparatus may be the cause of the left-sided predominance of CPSF.…”

Section: Discussionmentioning

confidence: 99%

“…The main clinical manifestations are recurrent neck abscess and suppurative thyroiditis that are predominantly left sided. [ 1 – 2 ] Most clinical literature on CPSF exists in the form of case reports. Large clinical reports and systematic studies are rare.…”

Section: Introductionmentioning

confidence: 99%

“…As such, CPSF cases are often misdiagnosed in clinical practice. [ 2 – 3 ] The traditional treatment for CPSF in acute infection stage (AIS) is conservative, which mainly includes incision and drainage of neck abscess and anti-infective treatment. During the non infection stage (NIS) complete surgical excision of the fistula associated hemithyroidectomy is performed.…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Chen

et al. 2021

Medicine

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“…However, it is difficult to find the fistula in traditional open-neck surgery, or the resection is incomplete, which may lead to recurrence (1,6). In recent years, minimally invasive endoscopic occlusion of the internal opening for the treatment of PSF is performed, including biocauterization (7), electrocautery (8), chemocautery (9), coblation (10), laser cauterization (11), and suture closure (6), etc. But only a few cases are reported with high recurrence rate.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Nursing Cooperation in Endoscopy-Assisted Surgery of Pyriform Sinus Fistula in Chinese Children: Experience in 196 Cases

Wang

et al. 2019

Iran J Pediatr

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Objectives: To summarize the experience of intraoperative nursing cooperation in endoscopy-assisted surgery of pyriform sinus fistula (PSF) in children. Methods: The charts of 196 children diagnosed with PSF undergone endoscopy-assisted surgery during August 2010 to August 2018 were retrospectively analyzed and in particular, the nursing cooperation reviewed. Results: All 196 cases were treated with endoscopy-assisted surgery following induction of general anesthesia with endotracheal intubation. Fistula tract was successfully found and completely resected. Good outcome was achieved in all but five patients during a follow-up of 2 months to 8 years. One patient had temporary hoarseness after surgery and recovered after 3 months. One patient developed left-side Horner's syndrome. PSF recurred in 3 cases. Conclusions: Endoscopy-assisted surgery for PSF consists of two parts: endoscopy assistance and open-neck operation resection. As a combined surgery, there are integral parts for operating room nurses to make full preparation, understand the surgical method, master the surgical procedures and special requirements, strengthen the cooperation and collaboration closely with surgical personnel to ensure successful operation.

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“…Complications and recurrence also occurred. Researchers have increasingly advocated for endoscopic cauterization of the sinus tract opening in the pyriform sinus [17, 20–22]. Unfortunately, this method will create a closed cavity.…”

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confidence: 99%

Third or fourth branchial pouch sinus lesions: a case series and management algorithm

Lyu

Wen

et al. 2019

J of Otolaryngol - Head & Neck Surg

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BackgroundThe purpose of this study was to develop an effective management algorithm for lesions of third or fourth branchial sinuses.Study designCase series with chart review.MethodsData from patients who were identified as having third or fourth branchial pouch sinus lesions in a single institution between January 2014 and December 2018 were retrospectively collected.ResultsAll 67 patients underwent fistulectomy. First, we classified the patients into five types based on their anatomic features. Then, we considered four optimized surgical methods and adopted the appropriate method with full consideration of the patient’s clinical characteristics. The great majority of cases occurred on the left side of the neck (68.7%) and most commonly presented as either a recurrent low-neck abscess or cutaneous discharging fistula with neck infection. Effective preoperative examination included administering contrast agent prior to a computed tomography (CT) scan and in-office laryngoscopy during the quiescent period of inflammation. Ultrasound was also very helpful in determining the presence of thyroiditis. The mean follow-up duration after excision of the lesion was 25.8 months. To date, only 1 (1.5%) recurrence and no obvious complications have been observed.ConclusionRefining fistula subtypes and adopting corresponding treatment measures can reduce the recurrence rate and improve curative effects. We propose and advocate this treatment algorithm for all third and fourth branchial pouch lesions.

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Endoscopic electrocauterization of pyriform sinus fistula

Cited by 16 publications

References 11 publications

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Intraoperative Nursing Cooperation in Endoscopy-Assisted Surgery of Pyriform Sinus Fistula in Chinese Children: Experience in 196 Cases

Third or fourth branchial pouch sinus lesions: a case series and management algorithm

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