Endoscopic diathermy cauterization of piriform fossa sinus tract (PFST)

Introduction

A congenital piriform fossa sinus tract is thought to be caused by a developmental abnormality of the third or fourth pharyngeal arches. This condition is traditionally managed by an open approach, external excision of sinus tract with hemi-thyroidectomy. However, endoscopic cauterization of PFST is now recognized as a minimally invasive definitive first line therapeutic option.

 

Objective

To evaluate the success of endoscopic cauterization of the PFST as a definitive first line therapeutic option.

 

Method

Retrospective analysis was done on medical records of ten patients (aged 1-12y), who were diagnosed with PFST and underwent endoscopic diathermy cauterization of PFST during one-year period (2015/2016) at LRH. Data including demography, presentation, management and response to treatment were analyzed.

 

Results

Median age of our case series was 8.23 years and eight out of ten patients (80%) were males. The most common presentation was recurrent thyroid abscess 60% (6/10) and the side of the disease was left in 90% (9/10). Eight out of ten (80%) patients had complete closure of the PFST after one session of endoscopic diathermy cauterization. Two out of ten (20%) patients had to undergo two sessions. Average follow up period was 17 months.

 

Conclusion

We propose the endoscopic diathermy cauterization as a safe and definitive first line therapeutic option in the management of the PFST.