title: Endoscopic cauterization of congenital pyriform fossa sinus tracts: an 18-year experience.
abstract: OBJECTIVE
  Congenital pyriform fossa sinus tracts predispose to neck masses and neck abscesses in pediatric and occasionally adult patients. Traditional management involves open excision with substantial potential morbidity. Endoscopic management allows an alternative, less morbid treatment approach.
  
  
  OBJECTIVE
  To evaluate the long-term effectiveness of endoscopic cauterization as definitive treatment for pyriform fossa sinus tracts.
  
  
  METHODS
  Retrospective review of the medical records of 23 children (aged 7 months to 14 years) with pyriform fossa sinus tracts treated with endoscopic cauterization between 1995 and 2013 at a tertiary care children's hospital.
  
  
  METHODS
  Endoscopic electrocauterization of pyriform fossa sinus tract opening.
  
  
  METHODS
  Recurrence of symptoms after endoscopic treatment.
  
  
  RESULTS
  Twenty-one of 23 patients experienced no recurrence after their first endoscopic electrocauterization of the sinus tract. The 2 patients with recurrence experienced symptoms within 1 month of cauterization and were treated with either open excision or recauterization. Endoscopic cauterization was able to definitively treat 9 patients whose treatments with incision and drainage or open excision had failed. Mean (range) follow-up for the 15 patients with follow-up was 7.4 (0.10-14.2) years. No procedure-related morbidity was reported.
  
  
  CONCLUSIONS
  Endoscopic cauterization seems to be an effective and potentially permanent treatment for congenital pyriform fossa sinus tracts.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas.
authors.forename: Joel Y
authors.initials: JY
authors.lastname: Sun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Berg
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas.
authors.forename: John E
authors.initials: JE
authors.lastname: McClay
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007013:Hypopharynx / Q000002:abnormalities / Q000601:surgery; D007223:Infant; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010608:Pharyngeal Diseases / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D056144:Pyriform Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome