title: Endoscopic chemocauterization for pyriform sinus fistula in children.
abstract: BACKGROUND
  Although complete excision is the standard treatment for pyriform sinus fistula (PSF), it has recently been suggested that chemocauterization via the internal orifice of the fistula could be an effective non-invasive treatment for the condition. The present report describes the details of our experience with and the efficacy of endoscopic chemocauterization for pediatric PSF.
  
  
  METHODS
  Between January 2010 and June 2015, four patients were diagnosed with PSF and scheduled to undergo endoscopic chemocauterization. Under general anesthesia, trichloroacetic acid (TCA) solution was endoscopically injected through the opening of the fistula using a fine plastic tube. Esophagogram was obtained at 3 weeks after the procedure to search for recurrence. Complete closure of the fistula was confirmed on endoscopy at 2-3 months after chemocauterization.
  
  
  RESULTS
  Two of the four patients were treated once, and the remaining patients required further chemocauterization procedures. No recurrence developed in any patient after it had been confirmed that the fistula's internal orifice had been obliterated. Some transient complications, such as sore throat, nausea or temporary vocal fold paresis, occurred.
  
  
  CONCLUSIONS
  Chemocauterization with TCA seems to be a useful first-choice treatment for PSF.
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.
authors.forename: Satohiko
authors.identifier: http://orcid.org/0000-0003-3087-5222
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.|Department of Pediatric Surgery, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Oshio
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.
authors.forename: Mototoshi
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kano
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tsuji
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Morikawa
mesh_terms: D002424:Caustics / Q000627:therapeutic use*; D002425:Cautery / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D010608:Pharyngeal Diseases / Q000601:surgery*; D056144:Pyriform Sinus / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000601:surgery*; D014238:Trichloroacetic Acid / Q000627:therapeutic use*
chemical_list: D002424:Caustics; D014238:Trichloroacetic Acid
keywords: chemocauterization; pyriform sinus fistula; treatment; trichloroacetic acid