Chemocauterization Treatment for a Recurrent Case of Pyriform Sinus Fistula After Fistulectomy With Hemithyroidectomy in Neonate

Abstract

A six-year-old female was referred to the author owing to a recurrence of pyriform sinus fistula following a fistulectomy with left hemithyroidectomy in neonate. The author had a concern for re-operation due to the difficulty of surgery and occurrence of complications. Therefore, the author performed chemocauterization of the fistula. Under general anesthesia with tracheal intubation, the orifice of the fistula was confirmed using a flexible distal hood endoscope. The hood was pushed to the orifice of the fistula to form a cylinder around it. After inserting a fine tube, 0.4 ml of 20% trichloroacetic acid was directed into the fistula. Total chemocauterization of the fistular canal and surrounding orifice was observed, which was endoscopically confirmed. There were no complications. Seven months later, closure of the orifice of the fistula was observed under the same endoscope. Chemocauterization is an effective and recommended treatment for recurrent cases of pyriform sinus fistula.