Purpose Congenital pyriform sinus fistula (CPSF) often presents diagnosis and treatment challenges. This study aimed to explore the treatment principles and to evaluate the effectiveness of the hypothermia plasma cauterization with suspension laryngoscopy for CPSF. Methods The medical records of 56 patients with CPSF from January 2000 to December 2019 were retrospectively reviewed. Results Of the 56 cases, the lesions were predominantly located on the left side (95%), and the accuracy of the first diagnosis was 30%. Ultrasound showed an abnormal rate of 86%, while CT or MRI displayed an abnormal anatomic lesion of 92%. The 3D visual reconstruction enabled the analysis of morphological characteristics of CPSF. The positive predictive value of barium esophagography was 89%, whereas the positive rate of the internal opening in CPSF under local anesthesia laryngoscopy was 33%. Nine cases of sinus type underwent open resection, and the recurrence rate was 33%. Interestingly, ten patients with sinus type underwent hypothermia plasma cauterization with suspension laryngoscopy, leading to a success rate of 100% without apparent complications. Conclusions Hypothermia plasma cauterization with suspension laryngoscopy alongside 3D imaging is both minimally invasive and repeatable with neglectable complications, which has the potential to serve as the first-line treatment for CPSF in the future.

中文翻译：

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先天性梨状窦瘘的单中心治疗

目的先天性梨状窦瘘 (CPSF) 经常给诊断和治疗带来挑战。本研究旨在探讨悬吊喉镜低温等离子烧灼治疗CPSF的治疗原则和疗效。方法回顾性分析2000年1月至2019年12月56例CPSF患者的病历资料。结果 56例中病灶多位于左侧（95%），初诊准确率为30%。超声显示异常率为 86%，而 CT 或 MRI 显示异常解剖病变率为 92%。3D 视觉重建能够分析 CPSF 的形态特征。钡餐造影的阳性预测值为89%，而局麻喉镜下CPSF内开口的阳性率为33%。鼻窦型9例行开放切除，复发率为33%。有趣的是，10 名窦型患者采用悬吊喉镜进行低温等离子烧灼，成功率 100%，无明显并发症。结论 悬吊喉镜联合 3D 成像的低温等离子烧灼具有微创性和可重复性，并发症可忽略，有可能在未来作为 CPSF 的一线治疗。导致成功率 100%，没有明显的并发症。结论 悬吊喉镜联合 3D 成像的低温等离子烧灼具有微创性和可重复性，并发症可忽略，有可能在未来作为 CPSF 的一线治疗。导致成功率 100%，没有明显的并发症。结论 悬吊喉镜联合 3D 成像的低温等离子烧灼具有微创性和可重复性，并发症可忽略，有可能在未来作为 CPSF 的一线治疗。