title: Endoscopic electrocauterization of pyriform fossa sinus tracts as definitive treatment.
abstract: OBJECTIVE
  To (1) update the technique of endoscopic electrocauterization of patients with pyriform fossa sinus tracts and (2) evaluate its effectiveness as a definitive treatment.
  
  
  METHODS
  Retrospective case series with nine patients (age range, 3.3-16.1 years) who were diagnosed with pyriform fossa sinus tracts between 2000 and 2007 at a single tertiary care children's hospital and underwent endoscopic electrocauterization of the sinus tract. Data collected including age of diagnosis, presenting symptoms, time from presentation to diagnosis, diagnostic studies, prior and subsequent treatments, length of hospital stay, and recurrence, were reviewed and analyzed with descriptive statistics.
  
  
  RESULTS
  All nine patients presented with recurrent left or midline neck masses or abscesses. Seven patients (78%) had at least one previous incision and drainage procedures for abscess treatment. All patients had a computed tomography scan with findings suspicious for left-sided pyriform fossa sinus tract. The diagnosis was confirmed with laryngoscopy. For seven patients (78%), endoscopic electrocauterization was definitive treatment with no recurrences to date. Two patients (22%) had recurrent left neck abscesses after endoscopic treatment; these patients ultimately underwent excision of sinus tract with left thyroid lobectomy without complications or further recurrences.
  
  
  CONCLUSIONS
  Endoscopic electrocauterization of pyriform fossa sinus tracts is a safe and definitive treatment for most patients. We advocate this minimally invasive procedure as first line of treatment for pyriform fossa sinus tracts, reserving open excision with or without thyroid lobectomy for failures.
authors.affiliation: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Eunice Y
authors.initials: EY
authors.lastname: Chen
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Inglis
authors.forename: Henry
authors.initials: H
authors.lastname: Ou
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Perkins
authors.forename: Kathleen C Y
authors.initials: KC
authors.lastname: Sie
authors.forename: Joseph
authors.initials: J
authors.lastname: Chiara
authors.forename: Scott C
authors.initials: SC
authors.lastname: Manning
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D001934:Branchial Region; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed