CO2 laser cauterization approach to congenital pyriform sinus fistula

Shengcai Wang; Yuzhu He; Yamei Zhang; Jie Zhang; Rahul Shah; Guoshuang Feng; Xiaodan Li; Wentong Ge; Yuanhu Liu; Yongli Guo; Haihong Liu; Jun Tai; Xin Ni

doi:10.1016/j.jpedsurg.2017.06.020

CO₂ laser cauterization approach to congenital pyriform sinus fistula

J Pediatr Surg. 2018 Jul;53(7):1313-1317. doi: 10.1016/j.jpedsurg.2017.06.020. Epub 2017 Jun 28.

Authors

Shengcai Wang¹, Yuzhu He², Yamei Zhang¹, Jie Zhang¹, Rahul Shah³, Guoshuang Feng⁴, Xiaodan Li¹, Wentong Ge¹, Yuanhu Liu¹, Yongli Guo⁵, Haihong Liu¹, Jun Tai⁶, Xin Ni⁷

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China.
² Long-term system program medical student, Master's degree candidate in pediatric surgery at Beijing Children's Hospital, Capital Medical University, Beijing, China.
³ Children's National Health System, George Washington University School of Medicine, Washington, DC, USA.
⁴ Center for Clinical Epidemiology & Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, China.
⁵ Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China.
⁶ Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China. Electronic address: trenttj@163.com.
⁷ Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China. Electronic address: nixin@bch.com.cn.

PMID: 28689887
DOI: 10.1016/j.jpedsurg.2017.06.020

Abstract

Objective: To evaluate the efficacy of CO₂ laser cauterization with suspension microlaryngoscopy as a definitive surgical treatment for pediatric Congenital Pyriform Sinus Fistula (CPSF).

Material and methods: This is a cohort retrospective study. Thyroid function and cervical ultrasonography examinations were performed before operation. Enhanced magnetic resonance imaging (MRI) was performed on patients with a repeated infection (≥2 times) and/or if they had a prior open surgery. Patients were divided into two groups: the <8-year-old group and the ≥8-year-old group. The differences in the number of cauterization procedures between the two age groups and between the initial treatment and the retreatment groups were analyzed.

Results: CO₂ laser cauterizations with suspension microlaryngoscopy were performed for 104 CPSF patients. No complications occurred. Three patients had a recurrence in the follow-up. The number of surgical cauterization operations was fewer than 3 in 85.1% of the patients. There was no significant difference in the number of cauterizations among the different age groups or between the initial treatment and retreatment groups (P>0.05).

Conclusion: CO₂ laser cauterization with suspension microlaryngoscopy is a safe, effective, and minimally invasive approach to CPSF with optimal patient outcomes.

Type of study: Treatment Study.

Level of evidence: Level III.

Keywords: Branchial fistula; CO(2) laser cauterization; Congenital pyriform sinus fistula.

MeSH terms

Adolescent
Cautery / methods
Child
Child, Preschool
Female
Humans
Infant
Laryngoscopy / methods
Laser Therapy*
Lasers, Gas*
Magnetic Resonance Imaging
Male
Pharyngeal Diseases / congenital*
Pharyngeal Diseases / surgery
Pyriform Sinus / surgery*
Recurrence
Respiratory Tract Fistula / congenital*
Respiratory Tract Fistula / surgery
Retrospective Studies