Value of high‐definition laryngoscopy in the diagnosis of pyriform sinus fistula

Objective Efficient methods are available to diagnose pyriform sinus fistula (PSF). This study aimed to assess the value of high‐definition laryngoscopy (HDL) in the diagnosis of PSF. Methods From January 2017 to December 2019, patients with PSF were enrolled into this study. HDL was performed without general anesthesia. Laryngoscopy characteristics were analyzed. An inner orifice in the pyriform fossa indicated the presence of PSF. The diagnostic accuracy of HDL was compared to that of barium swallow. Results A total of 56 patients (33 males and 23 females, ages 2–57 years) were included. The positive predictive value of HDL was 96.4%, and that of barium swallow was 89.2%. Compared to pronouncing the English letter “e,” anterior cervical skin traction plus Valsalva maneuver could offer a clearer view of the inner orifice in the pyriform fossa ( χ 2 = 11.187, p < 0.05). Nevertheless, compared to barium swallow, HDL showed no statistically significant difference in diagnosing PSF ( χ 2 = 2.598, p > 0.05). Conclusions Both HDL and barium swallow have their advantages and are complementary in diagnosing PSF. Their combination may achieve a higher diagnostic accuracy for PFS.