Value of modified Killian′s method in diagnosis of congenital pyriform sinus fistula
10.3760/cma.j.issn.1673-0860.2017.10.006
- VernacularTitle: 改良Killian法电子喉镜检查在先天性梨状窝瘘诊断中的应用
- Author:
Shuling HUANG
1
;
Liangsi CHEN
1
;
Bei ZHANG
1
;
Lu LIANG
2
;
Xixiang GONG
1
;
Zhenggen ZHOU
3
;
Shuixing ZHANG
3
;
Xiaoning LUO
1
;
Zhongming LU
1
;
Siyi ZHANG
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
2. Department of Otorhinolaryngology, Nansha Hospital of Guangzhou First People′s Hospital, Guangzhou 510515, China
3. Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Publication Type:Journal Article
- Keywords:
Congenital abnormalities;
Tomography, X-ray computed;
Diagnosis;
Congenital pyriform sinus fistula;
Barium swallow X-ray
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2017;52(10):744-748
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and significance of modified Killian(MK) method in the clinical diagnosis of congenital pyriform sinus fistula(CPSF) by electronic laryngoscopy.
Methods:The following examinations were performed for 30 suspected cases of CPSF, including the traditional electronic laryngoscopy, MK examination(modified Killian position+ head rotation+ the Valsalva maneuver), barium swallow X-ray(BSX) and CT , and a prospective comparison among them were done. Patients were divided into two groups according to their age: young age group(≤14 years old) and older age group (>14 years old). The results of MK examination from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ2 tests.
Results:Sinuses in 20 of 30 patients were depicted from pyriform sinus in BSX, and the PDR was 66.7%(20/30). The PRD of CT was 83.3%(25/30). The presence of air bubbles around the upper lobe of the thyroid gland or at the inferomedial edge of cricothyroid joints, morphological changes of thyroid grand as well as pseudo-fistula formation on lower neck were detected clearly on CT. Comparing to the traditional electronic laryngoscopy, the effect of exposing piriform fossa fistula by MK examination is significant(χ2=17.05, P<0.05), with the PDR of 13.3%(4/30) and 76.7%(23/30) respectively. Nevertheless, comparing to BSX and CT, there were no statistically significant differences in the effect to diagnose CPSF (χ2=0.31, χ2=0.10 respectively, P>0.05). The PDR of MK in older group is significantly higher than younger group(χ2=6.68, P<0.05).
Conclusions:MK examination can clearly reveal the hypopharyngeal anatomical structure and detect the sinus of CPSF .It could be a safe, feasible, convenient and economical method as an application in preoperative diagnosis and follow-up examination of clinical suspected CPSF.
