内镜下射频消融治疗儿童急性感染期梨状窝瘘

目的　观察显微支撑喉镜下射频消融治疗儿童急性感染期梨状窝瘘的临床疗效。方法　回顾性分析2017年1月~2019年10月我科收治的21例急性感染期梨状窝瘘患者的临床资料，所有患儿均在全麻下行显微支撑喉镜下射频消融封闭梨状窝瘘内瘘口，同时行颈部脓肿切开引流术。术后留置胃管2 w，抗生素治疗1～2 w，颈部换药3 w内痊 愈。观察分析患儿术后疗效、复发率及并发症等情况。结果  术后随访3～36个月，3例患儿出现一过性声嘶，术后3个月内恢复正常。所有患儿梨状窝瘘内瘘口1次封闭，无复发，无咽瘘、呛咳、喉返神经损伤、大出血等并发症。结论　内镜下射频消融术联合颈部脓肿切开引流术，推荐作为急性感染期梨状窝瘘的首选治疗方案。

Endoscopic coblation treatment for pediatric congenital pyriform sinus fistula in acute infection stage

OBJECTIVE To observe the clinical efficacy of endoscopic coblation in thetreatment of pediatriccongenital piriform sinus fistula in acute infectionstage.METHODS The clinical data of 21 patients with congenital piriform sinus fistulain acute infection stage treated in our department from January 2017 to October 2019 were retrospectively analyzed.All the patients were treated with radiofrequency ablation under suspend laryngoscope under general anesthesia,and neck abscess incision and drainage were performed at the same time.After operation,gastric tube was indwelling for 2 weeks,antibiotic treatment was performed for 1-2 weeks,and the neck was recovered within 3 weeks after dressing change.The curative efficacy,recurrence rate and complications were observed and analyzed.RESULTS During the follow-up period of 3 to 36 months,3 cases had transient hoarseness and recovered to normal within 3 months after operation.There was no recurrence,pharyngeal fistula,cough,recurrent laryngeal nerve injury,massive hemorrhage and otherpostoperative complications.CONCLUSION Endoscopic coblation combined with abscess incision and drainage is recommended as the first choice for treatment of congenital pyriform sinus fistula in acute infection stage.