Objective: To investigate a minimally invasive treatment method for piriform sinus fistula during infection. Methods: A retrospective analysis was performed on children diagnosed with pyriform sinus fistula infection at the Women’s and Children’s Hospital of Qingdao University from January 2022 to December 2024. All patients underwent ultrasound-guided puncture combined with endoscopic low-temperature plasma closure of the internal fistula. Successful treatment was defined as complete fistula closure following a single hospitalization and surgical procedure. Results: A total of 14 children (7 males and 7 females) were included, of whom 12 had left-sided lesions and 2 had right-sided lesions. In all 14 cases, the internal fistula scar in the piriform sinus healed well, exhibiting only slight mucosal edema. MRI findings showed significant reductions in cystic cavity size and relief of airway compression. Fiberoptic laryngoscopy confirmed closure of the internal fistula without evident tissue swelling. Postoperative dysphagia occurred in 4 patients but resolved gradually within 1 week. No complications related to recurrent or superior laryngeal nerve injuries, such as hoarseness or cough, were observed. During a follow-up period of 6 to 24 months, 1 patient experienced relapse, while the remaining patients exhibited no swelling or symptoms of respiratory compression. Conclusion: Ultrasound-guided puncture combined with endoscopic low-temperature plasma closure is an effective, minimally invasive, and safe approach for the treatment of infected piriform sinus fistula. This method can serve as a minimally invasive therapeutic option during active infection.
Wang et al. (2026) studied this question.