儿童颈部梨状窝瘘诊治进展

梨状窝瘘多以小儿反复发作的单侧（左侧为主）颈部炎性脓肿或急性化脓性甲状腺炎等症状就诊，以往在治疗上多为反复颈部脓肿切开引流及联合多种抗生素对症缓解症状或是开放性常规分离瘘管手术寻求根治，但复发率较高。该文通过总结近年梨状窝瘘相关诊断和治疗进展，旨在强调对于疑似患儿需及时行超声、CT、上消化道钡餐等检查，必要时做内镜检查，治疗上在非急性期以内镜辅助下导管置入或亚甲蓝内口注射行梨状窝瘘切除术可明显减少复发率。

Progress in diagnosis and treatment of pyriform fistula in children

Pyriform sinus fistula,owing to rare disease incidence and lacking of awareness,is always a puzzle to neck illness. At the mean time,The frequent delay in accurate diagnosis was reported in the literature. Pyriform sinus fistula should be considered in any children with repeated neck or thyroid infection/mass（ mainly on the left side） . The combination of barium esophagography,CT scan and ultrasound is useful to establish the diagnosis. Intraoperative endoscopy-assisted intubation or methylene blue injection through the internal opening as a guide can facilitate identification of the tract during dissection,and it can effectively reduce the relapse rate.