Tags

Type your tag names separated by a space and hit enter

Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy.
World J Clin Cases. 2019 Dec 06; 7(23):3957-3963.WJ

Abstract

BACKGROUND

Treatment of fistulas arising from the third branchial cleft includes endoscopic cauterization or open cervical fistulectomy. Both approaches are associated with recurrence rates of 14%-18%, and possibly greater rates when the fistula has been treated operatively beforehand. Treatment of fistulas arising from the third branchial cleft is associated with an inordinate recurrence rate. Recurrence may be multifactorial and related to incomplete resection of all of the anatomical elements of the fistula.

AIM

To present a new approach that involves complete resection of the recurrent fistula by a combined therapeutic approach.

METHODS

Here, 12 adult patients diagnosed with recurrent third branchial cleft fistulas underwent a combined therapy assisted by flexible fiber-optic pharyngoscopy to identify and resect the entry site of the fistula into the pyriform sinus. The fistulous opening into the pyriform sinus was identified by flexible fiber-optic pharyngoscopy. The application of intubation with a guidewire by pharyngoscopy, in addition to the removal of the partial excision of the thyroid cartilage, allowed complete resection of the opening and all parts of the fistula tract.

RESULTS

All of the internal openings of the fistulas in the pharynx were found and easily identified by flexible fiber-optic pharyngoscopy. All of the 12 patients underwent complete resection of the recurrent fistula by the combined therapeutic approach. There were no postoperative complications such as parapharyngeal abscess or wound infection, injury or dysfunction of the recurrent laryngeal or superior laryngeal nerves. The pharyngeal edema had degraded, and the pharyngeal wound healed postoperatively within 1 wk. Laryngeal endoscopy and voice analysis were performed on the 14th d post-operatively. Vocal cord movements did not change. The characters of voice for jitter, shimmer, and normalized noise energy were all within normal limits. In addition, no recurrences were observed during the 13-60 mo follow-up period.

CONCLUSION

It can be concluded that the proposed combined therapy is associated with excellent results, minimal morbidity, and no recurrence.

Authors+Show Affiliations

Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu Province, China.Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu Province, China.Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu Province, China.Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu Province, China.Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu Province, China. huang1963618@sohu.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31832397

Citation

Ding, Xiao-Qiong, et al. "Resection of Recurrent Third Branchial Cleft Fistulas Assisted By Flexible Pharyngotomy." World Journal of Clinical Cases, vol. 7, no. 23, 2019, pp. 3957-3963.
Ding XQ, Zhu X, Li L, et al. Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy. World J Clin Cases. 2019;7(23):3957-3963.
Ding, X. Q., Zhu, X., Li, L., Feng, X., & Huang, Z. C. (2019). Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy. World Journal of Clinical Cases, 7(23), 3957-3963. https://doi.org/10.12998/wjcc.v7.i23.3957
Ding XQ, et al. Resection of Recurrent Third Branchial Cleft Fistulas Assisted By Flexible Pharyngotomy. World J Clin Cases. 2019 Dec 6;7(23):3957-3963. PubMed PMID: 31832397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resection of recurrent third branchial cleft fistulas assisted by flexible pharyngotomy. AU - Ding,Xiao-Qiong, AU - Zhu,Xin, AU - Li,Ling, AU - Feng,Xu, AU - Huang,Zhi-Chun, PY - 2019/09/03/received PY - 2019/10/29/revised PY - 2019/11/15/accepted PY - 2019/12/14/entrez PY - 2019/12/14/pubmed PY - 2019/12/14/medline KW - Branchial cleft fistula KW - Fiber-optic pharyngoscopy KW - Guidewire KW - Pyriform sinus fistula KW - Resection SP - 3957 EP - 3963 JF - World journal of clinical cases JO - World J Clin Cases VL - 7 IS - 23 N2 - BACKGROUND: Treatment of fistulas arising from the third branchial cleft includes endoscopic cauterization or open cervical fistulectomy. Both approaches are associated with recurrence rates of 14%-18%, and possibly greater rates when the fistula has been treated operatively beforehand. Treatment of fistulas arising from the third branchial cleft is associated with an inordinate recurrence rate. Recurrence may be multifactorial and related to incomplete resection of all of the anatomical elements of the fistula. AIM: To present a new approach that involves complete resection of the recurrent fistula by a combined therapeutic approach. METHODS: Here, 12 adult patients diagnosed with recurrent third branchial cleft fistulas underwent a combined therapy assisted by flexible fiber-optic pharyngoscopy to identify and resect the entry site of the fistula into the pyriform sinus. The fistulous opening into the pyriform sinus was identified by flexible fiber-optic pharyngoscopy. The application of intubation with a guidewire by pharyngoscopy, in addition to the removal of the partial excision of the thyroid cartilage, allowed complete resection of the opening and all parts of the fistula tract. RESULTS: All of the internal openings of the fistulas in the pharynx were found and easily identified by flexible fiber-optic pharyngoscopy. All of the 12 patients underwent complete resection of the recurrent fistula by the combined therapeutic approach. There were no postoperative complications such as parapharyngeal abscess or wound infection, injury or dysfunction of the recurrent laryngeal or superior laryngeal nerves. The pharyngeal edema had degraded, and the pharyngeal wound healed postoperatively within 1 wk. Laryngeal endoscopy and voice analysis were performed on the 14th d post-operatively. Vocal cord movements did not change. The characters of voice for jitter, shimmer, and normalized noise energy were all within normal limits. In addition, no recurrences were observed during the 13-60 mo follow-up period. CONCLUSION: It can be concluded that the proposed combined therapy is associated with excellent results, minimal morbidity, and no recurrence. SN - 2307-8960 UR - https://www.unboundmedicine.com/medline/citation/31832397/Resection_of_recurrent_third_branchial_cleft_fistulas_assisted_by_flexible_pharyngotomy L2 - http://www.wjgnet.com/2307-8960/full/v7/i23/3957.htm DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.