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Vol. 68. Issue 4.
Pages 220-225 (July - August 2017)
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Vol. 68. Issue 4.
Pages 220-225 (July - August 2017)
Brief communication
Endoscopic Electrocauterization for Congenital Pyriform Sinus Fistula Treatment in Paediatrics. Case Series
Electrocauterización endoscópica para el tratamiento de las fístulas congénitas del seno piriforme en pediatría. Serie de casos
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Giselle Cuestasa,
Corresponding author
giselle_cuestas@yahoo.com.ar

Corresponding author.
, Flavia Doormanna, Verónica Rodrígueza, Patricio Bellia Munzóna, Gastón Bellia Munzónb
a Sección de Endoscopia Respiratoria, División de Otorrinolaringología, Hospital General de Niños Dr. Pedro de Elizalde, Buenos Aires, Argentina
b Servicio de Cirugía, Hospital General de Niños Dr. Pedro de Elizalde, Buenos Aires, Argentina
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Table 1. Patients With Pyriform Sinus Fistula Treated With Endoscopic Electrocauterisation.
Abstract

Pyriform sinus fistulas are rare anomalies of the branchial arches. Most of them are located on the left side. They extend from the apex of the pyriform sinus of the hypopharynx to the thyroid gland or adjacent tissues.

The diagnosis is suspected in the presence of acute suppurative thyroiditis or recurrent cervical abscesses, and is confirmed by endoscopic visualisation of the fistula hole. The traditional treatment consists of excision of the fistulous tract, with or without thyroid lobectomy, by cervical approach. However, less invasive alternatives that obliterate the path of the fistula have been developed, such as endoscopic electrocautery.

We describe our experience with 7 patients with this condition, who were treated with endoscopic cauterization using radiofrequency electrocautery, and we evaluate the effectiveness and safety of the treatment performed.

Keywords:
Pyriform sinus fistula
Endoscopic treatment
Radiofrequency
Paediatrics
Resumen

Las fístulas del seno piriforme son anomalías infrecuentes de los arcos branquiales. La mayoría se localizan en el lado izquierdo y se extienden desde el ápex del seno piriforme de la hipofaringe hasta la glándula tiroides o el espacio peritiroideo.

El diagnóstico se sospecha ante la presencia de tiroiditis aguda supurada o abscesos cervicales laterales recurrentes, y se confirma mediante la visualización endoscópica del orificio de la fístula. El tratamiento clásico consiste en la exéresis del trayecto fistuloso por vía cervical, con o sin lobectomía tiroidea. Sin embargo, se han desarrollado alternativas menos invasivas y con menos riesgos de complicaciones que obliteran el trayecto de la fístula, como la electrocauterización endoscópica.

Describimos nuestra experiencia con 7 pacientes que presentaban esta afección, tratados con cauterización endoscópica utilizando electrobisturí de radiofrecuencia, y evaluamos la eficacia y la seguridad del tratamiento realizado.

Palabras clave:
Fístula del seno piriforme
Tratamiento endoscópico
Radiofrecuencia
Pediatría

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