The Clinical Analysis Of Two Operation Methods For Treatment Of Congenital Pyriform Sinus Fistula

BackgroundCongenital pyriform sinus fistula is a congenital disease of the head and neck.These fistulas have a left-sided predominance and usually are diagnosed in childhood.They are mainly manifested as recurrent cervical abscess or acute suppurativethyroiditis.These diseases are uncommon and mostly case reports in both domesticand foreign literatures. Esophageal radiography, CT and laryngoscope are helpful todiagnose this disease.At present,treatment for congenital pyriform sinus fistulamainly by operation. The traditional way is complete surgical excision of thefistula,which needs to anatomize recurrent laryngeal nerve and remove all or part ofthe thyroid gland. With the further understanding of the disease,at present we use themethod of endoscopic electrocauterization to treat congenital pyriform sinus fistulaand achieve good results.ObjectiveTo analysis and summarize on the embryonic origin, anatomical characteristics,clinical features, diagnosis and treatment of congenital pyriform sinus fistula. Tocompare the curative effect of endoscopic electrocauterization and traditional opensurgery in the treatment of congenital pyriform sinus fistula. MethodsA retrospective analysis was undertaken for33patients with congenital pyriformsinus fistula from January2011to December2013at Department ofOtolaryngology,the First Affiliated Hospital of Zhengzhou University.16patientswere treated by endoscopic electrocoagulation,17cases underwent traditional openoperation. The operation time,postoperative hospital stay, cure rate, recurrence rateand complications were compared.ResultsThere were statistically significant differences between the cure rate oftraditional group and the endoscopic group（P＜0.05）.There were statisticallysignificant differences between the two groups in the operation time（P＜0.05）.Twogroups of postoperative hospital stay had no statistically significance（P＞0.05）.Therewere no complications in the endoscopic group,but6of them were recurrent. In thetraditional group,2cases of them had recurrent laryngeal nerve paralysis and1ofthem were recurrent.ConclusionsThe cure rate of traditional open surgery is higher than endoscopicelectrocauterization, but the operation time is long and it has more complications andsurgical trauma. Endoscopic electrocauterization has the advantages of simpleoperation, short operation time, less pain, fewer complications in patients,althoughthe recurrence rate is higher than open surgery,but it is still worthy to have a try.