Related Experiment Video
Updated: Jun 18, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
A Decade of Single-Center Experience in Children With Congenital Pyriform Sinus Fistula (CPSF)
Tingting Ji1, Ting Long1, Yuwei Liu1
1Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Carbon dioxide (CO2) laser cauterization is a safe and effective treatment for pediatric congenital pyriform sinus fistula (CPSF), showing a low recurrence rate and minimal complications. This method is a viable therapeutic option for managing CPSF in children.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Laser Surgery
Background:
- Congenital pyriform sinus fistula (CPSF) is a rare condition in children.
- Surgical management of CPSF can be challenging, with varying outcomes.
- Minimally invasive techniques are increasingly explored for pediatric surgical conditions.
Purpose of the Study:
- To evaluate the efficacy and safety of CO2 laser cauterization for pediatric CPSF.
- To assess long-term outcomes following CO2 laser cauterization.
- To identify predictors for the number of laser cauterization procedures required.
Main Methods:
- Retrospective analysis of clinical data from children with CPSF treated with CO2 laser cauterization.
- Procedures performed using suspension laryngoscopy and microscopy.
- Multiple logistic regression used to identify predictors of procedure count.
Main Results:
- 238 children with CPSF were included; 235 achieved successful fistula closure with CO2 laser cauterization.
- Median follow-up was 6.46 years; only 1.3% experienced recurrence requiring open surgery.
- Age at first operation was an independent risk factor for the number of procedures; no permanent complications were reported.
Conclusions:
- CO2 laser cauterization is an effective and safe treatment for pediatric CPSF.
- The procedure demonstrates a low recurrence rate and minimal complications.
- CO2 laser cauterization is a recommended therapeutic option for pediatric CPSF management.
Objectives:
To investigate the efficacy and safety of carbon dioxide (CO2) laser cauterization in the treatment of pediatric congenital pyriform sinus fistula (CPSF), and to track and follow up the long-term outcome of the postoperative patients.
Methods:
This retrospective study was conducted at a single center, where clinical data and follow-up information of children with CPSF who underwent CO2 laser cauterization with the assistance of a suspension laryngoscope and microscope were collected and analyzed their clinical characteristics and prognosis. Subsequently, multiple logistic regression analysis was performed to identify potential predictors of the number of laser cauterization procedures.
Results:
A total of 238 children diagnosed with CPSF were recruited for this study, with 235 patients successfully achieving closure of the internal fistula through one or more CO2 laser cauterization procedures without recurrence. The median duration of follow-up was 6.46 (5.20, 7.64) years. Merely three patients (1.3%) developed recurrent cervical infection and eventually underwent open neck surgery. There were no instances of permanent perioperative complications throughout the follow-up. Additionally, our analysis revealed that the age at the first operation of CO2 laser cauterization was an independent risk factor associated with the number of operations.
Conclusions:
The CO2 laser cauterization for children with CPSF is an effective and safe treatment with a low recurrence rate and minimal complications during the follow-up period. Consequently, it is advisable to consider CO2 laser cauterization as a viable therapeutic option for managing pediatric CPSF.
Level Of Evidence:
4 Laryngoscope, 134:5193-5200, 2024.
