Diagnosis and management of pyriform sinus cyst in neonates: 16-year experience at a single center.

BACKGROUND/PURPOSE: The purpose of this study was to review our experience in diagnosing and managing neonatal pyriform sinus cyst (PSC) and to assess its outcomes.

METHODS

We retrospectively reviewed 38 cases of neonatal PSC from 2001 to 2016. Clinical features, PSC diagnosis, treatment, and outcomes were analyzed.

RESULTS

Cervical masses were detected prenatally in 8 patients (21.1%). Neck cyst and respiratory distress were frequent symptoms among these patients. Preoperative PSC diagnosis was made in 15 cases (39.5%) by esophagography. CT or MRI images showed an air-filled cyst in 22 patients (57.9%). Cyst drainage was performed in 8 infected cases (21.1%). Cyst and fistula excision was performed in 30 cases (78.9%). Fistula excision assisted by endoscopy was required in 13 PSC patients (34.2%). Fistula detection failed in 4 cases (10.5%). Patients aged between 0 to 7days presented with low infection and high cyst removal rate. No fistula recurrence occurred in cases with cyst resection.

CONCLUSIONS

CT or MRI images with an air-filled cyst are significant indications in diagnosing PSC. Surgical options for PSC depend on levels of cervical infection. The optimal timing for surgical intervention is between 0 to 7days after birth. Our surgical approaches were effective in treating neonatal PSC.

LEVELS OF EVIDENCE

Treatment study, level IV (retrospective study).