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Treatment of piriform fossa sinuses with monopolar diathermy

Published online by Cambridge University Press:  01 August 2007

J Ahmed ,
S De ,
I D B Hore ,
C M Bailey  and
B E J Hartley
J Ahmed
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK
S De*
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK
I D B Hore
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK
C M Bailey
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK
B E J Hartley
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK
*
Address for correspondence: Miss S De, ENT Fellow, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK. Fax: 0208 78298644 E-mail: sude@doctors.org.uk
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Abstract

Introduction:

Embryological remnants of third or fourth branchial pouches are a rare but important cause of recurrent neck abscesses in children. They are characterised by an internal opening in the piriform fossa. Traditional management involves surgical excision of the entire tract. We present our experience with the use of monopolar diathermy applied to the internal sinus opening as a treatment modality for this condition.

Materials and methods:

A retrospective, case report review was performed.

Results:

Four cases of piriform fossa sinus were treated with monopolar diathermy to the sinus opening via an endoscopic approach. The first three cases were treated in this way for recurrence, following external tract excision, while the fourth case had simultaneous excision of the tract and diathermy to the piriform fossa opening. There were no serious complications and no recurrence within a follow-up period ranging from nine to 27 months.

Discussion:

Obliteration of the internal opening of these sinuses by endoscopic diathermy is a safe and effective management option for this condition, either as an alternative to or as an adjunct to external surgical excision of the tract.

Keywords

Branchial RegionSyndromeDiathermy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 8 , August 2008 , pp. 840 - 844
Copyright
Copyright © JLO (1984) Limited 2008

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