Background

Pyriform sinus fistula (PSF) is a rare branchial pouch anomaly of the neck that presents a diagnostic and management challenge. The objective of this study is to highlight the value of intraoperative suspension laryngoscope-assisted methylene blue injection through the internal opening as a guide for locating the fistula.

Methods

A retrospective study of 70 cases of PSF in children from 2009 to 2017 was managed, and an intraoperative suspension laryngoscope-assisted method combined with neck exploration and excision of the tract were performed in all cases.

Results

The patients comprised 36 males and 34 females ranging in age from 7 days to 15 years. Sixty-four cases were predominantly left-sided (64/70, 91.4%), and 6 cases (6/70, 8.6%) occurred on the right side. Four cases exhibited temporary postoperative hoarseness (4/70, 5.7%), which disappeared after one week. There were no instances of recurrence during follow-up ranging from two to nine years, and the median follow-up period was four years.

Conclusion

The use of our surgical approaches can facilitate the localization of the fistula during dissection in open neck surgery, and reduce recurrence.

中文翻译：

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梨状窦瘘70例回顾性分析

背景

梨状窦瘘 (PSF) 是一种罕见的颈部鳃囊异常，对诊断和治疗提出了挑战。本研究的目的是强调术中悬吊喉镜辅助亚甲蓝通过内开口注射作为瘘管定位指南的价值。

方法

对2009-2017年70例儿童PSF进行回顾性研究，所有病例均采用术中悬吊喉镜辅助结合颈部探查和导管切除的方法。

结果

患者包括36名男性和34名女性，年龄从7天到15岁不等。64 例主要发生在左侧（64/70，91.4%），6 例（6/70，8.6%）发生在右侧。4例术后出现暂时性声音嘶哑（4/70，5.7%），1周后消失。在 2 至 9 年的随访期间没有复发，中位随访期为 4 年。

结论

使用我们的手术方法可以促进开颈手术解剖过程中瘘管的定位，并减少复发。