Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T22:38:02.240Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Ford, GR, Balakrishnan, A, Evans, JN, Bailey, CM. Branchial cleft and pouch anomalies. J Laryngol Otol 1992;106:137–43CrossRefGoogle ScholarPubMed
2Edmonds, JL, Girod, DA, Woodroof, JM, Bruegger, DE. Third branchial anomalies. Avoiding recurrences. Arch Otolaryngol Head Neck Surg 1997;123:438–41CrossRefGoogle ScholarPubMed
3Nicollas, R, Ducroz, V, Garabedian, EN, Triglia, JM. Fourth branchial pouch anomalies: a study of six cases and review of the literature. Int J Pediatr Otorhinolaryngol 1998;44:5–10CrossRefGoogle ScholarPubMed
4Rea, PA, Hartley, BE, Bailey, CM. Third and fourth branchial pouch anomalies. J Laryngol Otol 2004;118:19–24CrossRefGoogle ScholarPubMed
5Yang, C, Cohen, J, Everts, E, Smith, J, Caro, J, Andersen, P. Fourth branchial arch sinus: clinical presentation, diagnostic workup, and surgical treatment. Laryngoscope 1999;109:442–6CrossRefGoogle ScholarPubMed
6Kim, KH, Sung, MW, Roh, JL, Han, MH. Sclerotherapy for congenital lesions in the head and neck. Otolaryngol Head Neck Surg 2004;131:307–16CrossRefGoogle ScholarPubMed
7Liston, SL. Fourth branchial fistula. Otolaryngol Head Neck Surg 1981;89:520–2CrossRefGoogle ScholarPubMed
8Godin, MS, Kearns, DB, Pransky, SM, Seid, AB, Wilson, DB. Fourth branchial pouch sinus: principles of diagnosis and management. Laryngoscope 1990;100:174–8CrossRefGoogle ScholarPubMed
9Agaton-Bonilla, FC, Gay-Escoda, C. Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients. Int J Oral Maxillofac Surg 1996;25:449–52CrossRefGoogle ScholarPubMed
10Jordan, JA, Graves, JE, Manning, SC, McClay, JE, Biavati, MJ. Endoscopic cauterization for treatment of fourth branchial cleft sinuses. Arch Otolaryngol Head Neck Surg 1998;124:1021–4CrossRefGoogle ScholarPubMed
11Pereira, KD, Losh, GG, Oliver, D, Poole, MD. Management of anomalies of the third and fourth branchial pouches. Int J Pediatr Otorhinolaryngol 2004;68:43–50CrossRefGoogle ScholarPubMed
12Verret, DJ, McClay, J, Murray, A, Biavati, M, Brown, O. Endoscopic cauterization of fourth branchial cleft sinus tracts. Arch Otolaryngol Head Neck Surg 2004;130:465–8CrossRefGoogle ScholarPubMed
13Stenquist, M, Juhlin, C, Astrom, G, Friberg, U. Fourth branchial pouch sinus with recurrent deep cervical abscesses successfully treated with trichloroacetic acid cauterization. Acta Otolaryngol 2003;123:879–82CrossRefGoogle ScholarPubMed
14Sayadi, SJ, Gassab, I, Dellai, M, Mekki, M, Golli, M, Elkadhi, F et al. Laser coagulation in the endoscopic management of fourth branchial pouch sinus. Ann Otolaryngol Chir Cervicofac 2006;123:138–42CrossRefGoogle ScholarPubMed