Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Otorhinolaryngology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
Laryngoscope. 2024 Dec;134(12):5193-5200. doi: 10.1002/lary.31668. Epub 2024 Jul 31.
To investigate the efficacy and safety of carbon dioxide (CO) laser cauterization in the treatment of pediatric congenital pyriform sinus fistula (CPSF), and to track and follow up the long-term outcome of the postoperative patients.
This retrospective study was conducted at a single center, where clinical data and follow-up information of children with CPSF who underwent CO laser cauterization with the assistance of a suspension laryngoscope and microscope were collected and analyzed their clinical characteristics and prognosis. Subsequently, multiple logistic regression analysis was performed to identify potential predictors of the number of laser cauterization procedures.
A total of 238 children diagnosed with CPSF were recruited for this study, with 235 patients successfully achieving closure of the internal fistula through one or more CO laser cauterization procedures without recurrence. The median duration of follow-up was 6.46 (5.20, 7.64) years. Merely three patients (1.3%) developed recurrent cervical infection and eventually underwent open neck surgery. There were no instances of permanent perioperative complications throughout the follow-up. Additionally, our analysis revealed that the age at the first operation of CO laser cauterization was an independent risk factor associated with the number of operations.
The CO laser cauterization for children with CPSF is an effective and safe treatment with a low recurrence rate and minimal complications during the follow-up period. Consequently, it is advisable to consider CO laser cauterization as a viable therapeutic option for managing pediatric CPSF.
4 Laryngoscope, 134:5193-5200, 2024.
探讨二氧化碳（CO）激光烧灼治疗小儿先天性梨状窝瘘（CPSF）的疗效和安全性，并对术后患者进行长期随访。
本回顾性研究在一家单中心进行，收集并分析了在支撑喉镜和显微镜辅助下接受 CO 激光烧灼治疗的 CPSF 患儿的临床资料和随访信息，以了解其临床特征和预后。随后，进行多因素逻辑回归分析以确定激光烧灼次数的潜在预测因素。
共纳入 238 例诊断为 CPSF 的患儿，235 例患者通过 1 次或多次 CO 激光烧灼成功闭合内瘘，无复发。中位随访时间为 6.46（5.20，7.64）年。仅有 3 例（1.3%）患者出现复发性颈感染，最终行开放颈部手术。整个随访过程中无永久性围手术期并发症。此外，我们的分析表明，CO 激光烧灼的首次手术年龄是与手术次数相关的独立危险因素。
CO 激光烧灼治疗小儿 CPSF 是一种有效且安全的治疗方法，复发率低，随访期间并发症少。因此，CO 激光烧灼可作为治疗小儿 CPSF 的一种可行的治疗选择。
4 级喉镜，134：5193-5200，2024。
