Clinical Study Of Radiofrequency Ablation In The Treatment Of Congenital Pyriform Sinus Fistula

BackgroundCongenital pyriform sinus fistula(CPSF)is a geneogenous disease of head and neck,which has some higher incidence in childhood than in adulthood.The main manifestations are recurrent neck mass,abscess and pyogenic thyroiditis.This disease is rare in clinic,complicated in diagnosis and easy to be misdiagnosed.Barium swallow of esophagus,laryngoscope and neck CT are helpful for the diagnosis of the disease.The treatment of congenital pyriform sinus fistula is mainly surgery.The traditional surgical method is open fistulectomy through external cervical approach.However,the operation is difficult,the possibility of complete separation and removal of fistula is small,trauma is large,and postoperative complications are many.With the rapid development and popularization of endoscopic technology in recent years,endoscopic minimally invasive operate of congenital pyriform sinus fistula is safer and easier to open neck operate,so it is selected by more scholars.ObjectiveThe purpose of this study was to investigate the diagnosis of congenital pyriform sinus fistula and evaluate the therapeutic effect of endoscopic ablation.MethodFrom March 2013 to May 2019,216 cases of congenital pyriform sinus fistula were treated by radiofrequency ablation under laryngoscope in the department of Otorhinolaryngology of the First Affiliated Hospital of Zhengzhou University.The basic clinical data included sex,age,location,clinical manifestation,imaging examination,postoperative complications and recurrence.The average follow-up was 15 months.ResultIn 216 patients,the ratio of male to female was 1.18:1,90.7%on the left,8.3%on the right and only 1.0%on both sides.The age of operation ranged from 23 days to 66 years.8 patients were lost.12 cases of recurrence were treated by radiofrequency ablation under laryngoscope for the first time,the recurrence rate is 5.8%,in which 9 cases were treated by adiofrequency ablation again and 3 cases were treated by neck fistulectomy.17(8.2%)patients had temporary hoarseness after operation,recovered 1?5 months after discharge,no permanent vocal cord paralysis.There were no dysphagia,infection,esophageal injury and other complications in 208 patients.Conclusion?For recurrent left cervical mass,abscess and acute suppurative thyroiditis,especially in children,congenital pyriform sinus fistula should be considered.?The incidence rate of male and female is basically the same.?Barium swallow examination of the esophagus is the first choice in the rest stage of inflammation because of its low cost and simple operation.Ultrasound and CT examination of the neck are of great significance in understanding the character of the lesions,the relation with the tissue around it and the differentiation from other neck diseases.?Radiofrequency ablation under laryngoscope is safe,easy to operate,high repeatability,low recurrence rate of minimally invasive surgery,which can be used as the first choice.