Chemocauterization Using a Distal Hood Endoscope for the Treatment of Pyriform Sinus Fistula

Abstract

Fistulectomy is a radical treatment for pyriform sinus fistula (PSF), which is prone to recurrence depending on the condition of the fistulous tract. Conventional chemocauterization was developed as a treatment option for PSF, but it could obliterate only the internal orifice of PSF, leaving the entire fistulous duct unobliterated. A distal hood endoscope was devised as a treatment option for PSF. A child received chemocauterization using a distal hood endoscope for the treatment of PSF. The operation was completed after confirming that the fistulous tract was influenced by trichloroacetic acid. Postoperatively, the closure of the internal orifice of PSF was confirmed by endoscopy and esophagography, and the shrinkage of the fistulous duct was visualized by ultrasound. The only complication was a transient sore throat. This novel method is more curative than conventional chemocauterization and may be a good treatment option for PSF.