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Pyriform sinus fistula: management with chemocauterization of the internal opening.
Ann Otol Rhinol Laryngol. 2000 May; 109(5):452-6.AO

Abstract

A branchial remnant originating in the pyriform sinus causes a recurrent fistula or abscess in the neck. In spite of excision, recurrence may result from inadequate removal of the fistula tract. We attempted chemocauterization of the internal opening of the fistula tract with trichloroacetic acid (TCA) on direct endoscopy. This is a 6-year review of 18 patients with pyriform sinus fistula. Medical history, barium esophagography, computed tomography scans, operative findings, and treatment results were analyzed. By direct endoscopy, all patients were found to have a fistula opening in the pyriform sinus, exclusively on the left side. In only 9 patients, the fistula tract was identified by barium esophagography before operation. Computed tomography revealed a suspicious fistula tract originating from the pyriform sinus in 8 of 10 patients. Sixteen patients were initially managed by TCA chemocauterization. There were no serious intraoperative or postoperative complications. Four patients had recurrent masses, which were managed by simple excision in 2 patients and repeated TCA cauterization in the other 2 patients with unobliterated internal openings. We recommend barium swallow study and direct endoscopy for all patients presenting with a recurrent lateral neck abscess, especially on the left side. Our results suggest that initial chemocauterization of the internal opening can be a reasonable alternative procedure for the management of pyriform sinus fistula.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10823473

Citation

Kim, K H., et al. "Pyriform Sinus Fistula: Management With Chemocauterization of the Internal Opening." The Annals of Otology, Rhinology, and Laryngology, vol. 109, no. 5, 2000, pp. 452-6.
Kim KH, Sung MW, Koh TY, et al. Pyriform sinus fistula: management with chemocauterization of the internal opening. Ann Otol Rhinol Laryngol. 2000;109(5):452-6.
Kim, K. H., Sung, M. W., Koh, T. Y., Oh, S. H., & Kim, I. S. (2000). Pyriform sinus fistula: management with chemocauterization of the internal opening. The Annals of Otology, Rhinology, and Laryngology, 109(5), 452-6.
Kim KH, et al. Pyriform Sinus Fistula: Management With Chemocauterization of the Internal Opening. Ann Otol Rhinol Laryngol. 2000;109(5):452-6. PubMed PMID: 10823473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pyriform sinus fistula: management with chemocauterization of the internal opening. AU - Kim,K H, AU - Sung,M W, AU - Koh,T Y, AU - Oh,S H, AU - Kim,I S, PY - 2000/5/24/pubmed PY - 2000/6/17/medline PY - 2000/5/24/entrez SP - 452 EP - 6 JF - The Annals of otology, rhinology, and laryngology JO - Ann. Otol. Rhinol. Laryngol. VL - 109 IS - 5 N2 - A branchial remnant originating in the pyriform sinus causes a recurrent fistula or abscess in the neck. In spite of excision, recurrence may result from inadequate removal of the fistula tract. We attempted chemocauterization of the internal opening of the fistula tract with trichloroacetic acid (TCA) on direct endoscopy. This is a 6-year review of 18 patients with pyriform sinus fistula. Medical history, barium esophagography, computed tomography scans, operative findings, and treatment results were analyzed. By direct endoscopy, all patients were found to have a fistula opening in the pyriform sinus, exclusively on the left side. In only 9 patients, the fistula tract was identified by barium esophagography before operation. Computed tomography revealed a suspicious fistula tract originating from the pyriform sinus in 8 of 10 patients. Sixteen patients were initially managed by TCA chemocauterization. There were no serious intraoperative or postoperative complications. Four patients had recurrent masses, which were managed by simple excision in 2 patients and repeated TCA cauterization in the other 2 patients with unobliterated internal openings. We recommend barium swallow study and direct endoscopy for all patients presenting with a recurrent lateral neck abscess, especially on the left side. Our results suggest that initial chemocauterization of the internal opening can be a reasonable alternative procedure for the management of pyriform sinus fistula. SN - 0003-4894 UR - https://www.unboundmedicine.com/medline/citation/10823473/Pyriform_sinus_fistula:_management_with_chemocauterization_of_the_internal_opening_ L2 - http://journals.sagepub.com/doi/full/10.1177/000348940010900503?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -