The clinical analysis of surgical management of pyriform sinus fistula

Abstract

Purpose: Pyriform sinus fistula is relatively rare disease with congenital hypopharynx fistula that cause neck abscess and acute suppurative thyroiditis. The radical treatment for this disease is fistulectomy using cervical approach. But, recently, it is suggested that chemocauterization of the internal opening of the fistula is safe and effective.

Methods: We retrospectively reviewed six cases (four boys and two girls, aged 4 to 15 years) with pyriform sinus fistula treated with fistulectomy, chemocauterization using by tricholoroacetic acid or silver nitrate between April 2000 and March 2016 at Nagano Children’s Hospital.

Results: Four patients were treated by fistulectomy, one was by tricholoroacetic acid cauterization, and one was by silver nitrate cauterization. Postoperative complications were occurred in the two cases of fistulectomy and one case of chemocauterization. Complications of fistulectomy were hoarseness and neck wound infection. That of chemocauterization was persistence of fistula. There were no recurrent neck abscess and acute suppurative thyroiditis in all cases.

Conclusions: Chemocauterization is less invasive than fistulectomy. Our experiences suggest that chemocauterization is the first choice of treatment for pyriform sinus fistula in children.