内镜CO2激光烧灼术治疗273例儿童先天性梨状窝瘘的临床分析

目的 了解儿童先天性梨状窝瘘CPSF临床特点,为规范化儿童CPSF的诊断及微创治疗方案提供依据.方法 回顾性分析2014～2021年确诊的CPSF患儿,所有患儿予单纯内镜下CO2激光烧灼术的标准治疗方案,经过一次或多次手术治疗达到治疗终点.结果 研究共纳入273例(6.28±3.33岁)患儿.术前行超声检查阳性率91....

A clinical analysis on children with congenital pyriform sinus fistula treated through microscopic laryngoscopy with CO2 laser cauterization

Objective The objective of this study is to explore the clinical characteristics of children with congenital pyriform sinus fistula(CPSF). It also aims to standardize its diagnosis and serve as a reference for the treatment of children with CPSF through microscopic laryngoscopy with CO₂ laser cauterization. Methods A retrospective, single-center study was conducted by analyzing the clinical data of children diagnosed with CPSF in Beijing Children's Hospital(BCH)from 2014 to 2021. Microscopic laryngoscopy involving CO₂ single-laser cauterization was performed on children with CPSF until the internal fistula completely closed after one or two procedures. Results A total of 273 patients(6.28±3.33 years)were enrolled in this study. Preoperative examination showed a positive predictive value(PPV)of 91.2% when ultrasonography was used, and 82.8% when enhanced magnetic resonance imaging(MRI)was used. All patients were treated with a standardized procedure of CO₂ laser cauterization in our center, with 173(63.0%)of the patients undergoing only one operation and 61(22.3%)of the patients undergoing two procedures until the internal fistulas completely closed. Multivariate logistic regression analysis showed that a history of open neck surgery was not related to the number of times the procedure was done. In contrast, the age at the first CO₂ laser cauterization surgery was an independent risk factor for the number of procedures needed for the internal fistula to close. All patients did not suffer severe postoperative complications. Conclusion Our study revealed that CO₂ laser cauterization is a therapeutic strategy that is effective, safe, and has repeatable results. This method can be the preferred treatment for pediatric CPSF.