The treatment of congenital pyriform sinus fistula: a single-center experience.
PURPOSE
Congenital pyriform sinus fistula (CPSF) often presents diagnosis and treatment challenges. This study aimed to explore the treatment principles and to evaluate the effectiveness of the hypothermia plasma cauterization with suspension laryngoscopy for CPSF.


METHODS
The medical records of 56 patients with CPSF from January 2000 to December 2019 were retrospectively reviewed.


RESULTS
Of the 56 cases, the lesions were predominantly located on the left side (95%), and the accuracy of the first diagnosis was 30%. Ultrasound showed an abnormal rate of 86%, while CT or MRI displayed an abnormal anatomic lesion of 92%. The 3D visual reconstruction enabled the analysis of morphological characteristics of CPSF. The positive predictive value of barium esophagography was 89%, whereas the positive rate of the internal opening in CPSF under local anesthesia laryngoscopy was 33%. Nine cases of sinus type underwent open resection, and the recurrence rate was 33%. Interestingly, ten patients with sinus type underwent hypothermia plasma cauterization with suspension laryngoscopy, leading to a success rate of 100% without apparent complications.


CONCLUSIONS
Hypothermia plasma cauterization with suspension laryngoscopy alongside 3D imaging is both minimally invasive and repeatable with neglectable complications, which has the potential to serve as the first-line treatment for CPSF in the future.
['Xia|Liguang|L|', 'Lin|Zhengxiu|Z|', 'Lin|Xiaokun|X|', 'Wang|Yongbiao|Y|', 'Zhu|Libin|L|', 'Lin|Jinhan|J|', 'Zhao|Yiming|Y|', 'Li|Zhongrong|Z|']
D000293:Adolescent D002425:Cautery D002648:Child D002675:Child, Preschool D003952:Diagnostic Imaging D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D007828:Laryngoscopy D008297:Male D056144:Pyriform Sinus D016156:Respiratory Tract Fistula D012189:Retrospective Studies D016896:Treatment Outcome
Treatment Congenital pyriform sinus fistula Hypothermia plasma cauterization Suspension laryngoscopy 3D reconstruction