1.Preliminary experience of ultrasound-guided puncture combined with endoscopic cauterization in the treatment of neonatal pyriform sinus fistula.
Yang ZHANG ; Jing BI ; Bo YU ; Yong FU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):152-157
Objective:To explore the diagnosis and minimal invasive treatment of neonatal pyriform sinus fistula. Methods:A retrospective analysis was conducted on the clinical data of newborns diagnosed with pyriform sinus fistula in the Children's Hospital, Zhejiang University School of Medicine from January 2016 to December 2023, including the diagnostic process and treatment methods. Results:There were 8 children, 2 males and 6 females, with 7 cases on the left side and 1 case on the right side. Six cases revealed a lump in the fetal neck during prenatal examination, and two cases were found to have a neck mass after birth. All cases presented with varying degrees of respiratory disorders. After admission, all patients underwent neck ultrasound and contrast-enhanced CT examination. Neck ultrasound showed cystic masses, with 3 of the cysts accompanied by septa, and an air-fluid level was observed in the cysts in 6 cases from contrast-enhanced CT. All patients underwent ultrasound-guided neck mass puncture and/or tube placement combined with endoscopic electrocauterization. The cystic fluid was found to be yellow and thin, with no signs of infection. The surgical operations were uneventful, and the follow-up time ranged from 12 to 72 months postoperatively. There were no complications such as hoarseness, and no recurrence cases were reported. Conclusion:Neonatal pyriform sinus fistula is often characterized by a large cystic mass in the neck combined with respiratory depression. The presence of an air-fluid level in the cyst from contrast-enhanced CT can be considered an important basis for early diagnosis of pyriform sinus fistula. Ultrasound-guided puncture combined with endoscopic electrocauterization is minimally invasive and safe, making it a suitable minimal invasive treatment for neonatal pyriform sinus fistula.
Humans
;
Female
;
Male
;
Pyriform Sinus/surgery*
;
Retrospective Studies
;
Infant, Newborn
;
Cautery/methods*
;
Endoscopy
;
Fistula/surgery*
;
Punctures
;
Tomography, X-Ray Computed
2.Clinical analysis of surgical treatment and postoperative efficacy in piriform sinus fistula with acute inflammatory period of children.
Yufeng GUO ; Xingqiang GAO ; Zhengmin XU ; Haiyan DENG ; Xiaohui WU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):158-162
Objective:To discuss the clinical efficacy of low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess for the treatment of congenital pyriform sinus fistula (CPSF) in the acute inflammatory period of children. Methods:Clinical data of 30 patients with CPSF in the acute inflammatory period who received low-temperature radiofrequency ablation assisted by endoscopy under laryngoscope, combined with resection and drainage of cervical abscess, from January 2018 to December 2023 were reviewed. After the operation, patients were followed up closely at different stages. All patients underwent color Doppler ultrasound and electronic laryngoscopy, and the results were analyzed. Results:All 30 children successfully completed the surgery without pharyngeal fistula, dysphagia, perifistula, or distal fistula infection, and the incision in the neck healed well. The follow-up survey ranged from 6 months to 2 years, and no recurrences were observed. Conclusion:Low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess is a promising method for treating CPSF in the acute inflammatory period. It is less traumatic, simple, safe, has a significant curative effect, and a low recurrence rate. This approach can be used as a supplementary operation for CPSF in children and provides a new way for clinical treatment.
Humans
;
Pyriform Sinus/abnormalities*
;
Abscess/surgery*
;
Drainage
;
Fistula/congenital*
;
Female
;
Male
;
Child
;
Radiofrequency Ablation
;
Treatment Outcome
;
Postoperative Period
;
Endoscopy
;
Laryngoscopy
;
Inflammation
;
Child, Preschool
3.One case of hypopharyngeal dedifferentiated liposarcoma.
Maolin YANG ; Yangling DU ; Jun ZHENG ; Jinshu MA ; Jichao SHA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(11):1099-1102
Differentiated liposarcoma is a rare connective tissue malignancy in adults that mostly occurs in the extremities and retroperitoneum, with a tendency to aggressiveness and recurrence, and the ten-year survival rate of about 10%. Clinically, dedifferentiated liposarcoma of the pharynx has been reported to be rare abroad and only one case has been reported in China. Clinical symptoms are mainly foreign body sensation in the pharynx, which can be easily misdiagnosed as benign tumors. Pathological diagnosis is the main examination tool for this kind of disease, and immunohistochemistry and FISH test can help to differentiate it from other tumors. This article presents a case of a male patient with dedifferentiated liposarcoma of the hypopharynx, who had a foreign body sensation in the pharynx for more than 1 month, and underwent supported laryngoscopic pharyngeal lesion resection after completing the preoperative relevant examinations and postoperative radiation therapy, with postoperative pathology returned as dedifferentiated liposarcoma. The present postoperative follow-up was 12 months without recurrence. Therefore, accurate diagnosis and timely treatment are extremely important for the prognosis of this disease.
Humans
;
Male
;
Liposarcoma/diagnosis*
;
Hypopharyngeal Neoplasms/diagnosis*
;
Middle Aged
;
Hypopharynx
;
Adult
4.Clinical application of Visual throat forceps in the removal of hypopharyngeal foreign body.
Zhonghua MENG ; Qirui ZOU ; Zhongcheng XING ; Shangqing ZHOU ; Zhen ZHANG ; Ye WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):80-82
Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.
Humans
;
Hypopharynx/surgery*
;
Pharynx/surgery*
;
Endoscopes
;
Surgical Instruments
;
Foreign Bodies/diagnosis*
5.Synovial sarcoma of the Hypopharynx in a Filipino female: A case report
Ariane Marielle F. Valle ; Eugene G. Odoñ ; o I
Acta Medica Philippina 2024;58(5):74-78
Synovial sarcoma of the hypopharynx is an uncommon malignancy, with less than 100 cases reported in available journals. We report a case of a 22-year-old female presenting with dysphagia and enlarging hypopharyngeal mass, clinically diagnosed as hypopharyngeal malignancy, right, at least stage III. Histopathologic examination including immunohistochemistry study with TLE1 and SS18 Fluorescence In Situ Hybridization (FISH) confirm the diagnosis of synovial sarcoma. This is the first reported case of synovial sarcoma of the hypopharynx in the Philippines confirmed by SS18 FISH. Due to the size of the mass, chemoradiotherapy followed by surgery is the current plan of management for this patient.
Sarcoma
;
Hypopharynx
6.The clinical value of recurrent laryngeal nerve dissection in the surgical treatment for congenital pyriform sinus fistula.
Liangzhong YAO ; Qifa LIN ; Liangsi CHEN ; Siqi WANG ; Xiangyue HAO ; Yanli ZHU ; Junjie LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):801-808
Objective:To explore the clinical value of recurrent laryngeal nerve dissection in the surgical treatment for congenital pyriform sinus fistula(CPSF). Methods:The clinical data of 42 patients with CPSF were retrospectively analyzed. All patients were diagnosed and treated in the First Affiliated Hospital of Guangdong Pharmaceutical University. Results:During the operation, all patients' recurrent laryngeal nerves were dissected successfully, and fistulas were resected completely,no patients had complication of recurrent laryngeal nerve's damage.There were no recurrence cases during the 13 to 48 months of follow-up. Conclusion:The trend of congenital pyriform sinus fistula is closely related to recurrent laryngeal nerve, it's important to dissect the recurrent laryngeal nerve during the operation for congenital pyriform sinus fistula.
Humans
;
Neck
;
Recurrent Laryngeal Nerve/surgery*
;
Retrospective Studies
;
Pyriform Sinus/surgery*
;
Fistula/surgery*
7.Piriform sinus hamartoma in children: a case report and literature review.
Zhiying ZHOU ; Wenxin CHEN ; Jia LIU ; Yong FU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):964-971
Objective:To investigate the clinical manifestations and treatment of laryngopharynx hamartoma in children. Methods:The clinical data of a child with piriform sinus hamartoma treated in our hospital were analyzed retrospectively. The age, gender, clinical manifestations, auxiliary examination, location of the tumor and surgical methods were analyzed. Results:The patient had a good prognosis after surgery, and no tumor recurrence was found after 1 year of follow-up. Conclusion:Laryngopharynx hamartoma is rare in children. It should be considered in children with laryngeal dysfunction and upper airway obstruction. Complete resection of the tumor is the key to postoperative recurrence.
Child
;
Humans
;
Hamartoma/surgery*
;
Larynx/pathology*
;
Neoplasm Recurrence, Local/pathology*
;
Pyriform Sinus/pathology*
;
Retrospective Studies
;
Male
;
Female
10.The modified Valsalva maneuver in hypopharynx CT scan.
Xuhui LIANG ; Fenglei XU ; Ming XIA ; Lihui ZHUANG ; Xiaoming LI ; Xiaozhi HOU ; Qi ZHANG ; Jiangfei YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(5):343-349
Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients(96.15%) completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing(Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01), while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing(Z=-3.625, P<0.01). In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
Humans
;
Hypopharynx/diagnostic imaging*
;
Valsalva Maneuver
;
Hypopharyngeal Neoplasms/surgery*
;
Tomography, X-Ray Computed
;
Carcinoma


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