Endoscopic Treatment Of Congenital Pyriform Sinus Fistula During Infection

Objective: To explore the feasibility and effectiveness of endoscopic treatment of congenital pyriform sinus fistula during infection.Methods: Forty patients of congenital congenital piriformis fistula at infection stage were divided into two groups.Open-only group: 10 patients underwent the neck abscess incision and clean-up(or fistula resection);endoscopic group: 30 patients underwent the resection + energy cauterization(monopolar electrocautery or plasma or CO2 laser)of the internal fistula under endoscopic,With incision and clearing of neck abscess(or fistula resection),and gastric tube remained for 7-14 days.Followed up for more than 1 year after operation,and the difference of postoperative efficacy and complications between the two groups of patients with different treatment methods were analyzed retrospectively.Results: In the open-only group,10 cases were treated,2 cases were cured(2/10=20%),and 8 cases relapsed.In the endoscopy group,30 cases were treated,24 cases were cured(24/30=80%,that is,the cure rate in the endoscopy group),and 6 cases relapsed.Conclusion: It is feasible to the treat congenital pyriform sinus fistula at infection stage with internal fistula treatment such as energy cauterization under endoscopy and indwelling gastric tube,which is more effective than open neck surgery alone.