先天性梨状窝瘘的外科治疗进展

Progress in surgery treatment of congenital pyriform sinus fistula

先天性梨状窝瘘（congenital pyriform sinus fistula,CPSF）是第三或第四鳃弓向内与对应的鳃囊相通,形成开口于梨状窝黏膜的窦道^（〔1〕）,包括第三和第四鳃裂畸形,发病率分别为2%~8%、1%~4%^（〔2-4〕）,好发于左侧,80%以上在儿童期发病^（〔5〕）。临床典型表现为反复发作的颈部脓肿、急性化脓性甲状腺炎等,伴吞咽疼痛或困难、呼吸窘迫。

Congenital pyriform sinus fistula（CPSF）is a rare brancial cleft deformity in neck,characterized by acute suppurative thyroiditis,recurrent cervical abscesses and cellulitis.At present,surgical treatment of CPSF include traditional surgery and endoscopic cauterization.In the past,en block resection of the fistula by surgery is the only cure method.The late 90,relatively safe and effective endoscopic and minimally invasive aesthetic surgery is applied in treatment of CPSF,and was recommended as the preferred treatment for congenital pyriform sinus fistula.From the long-term efficacy,which method is more dominant,yet to be elegant.Through the analysis of embryo principles and anatomy of CPSF,we introduce and summarize the indications,complications and prevention in conventional surgical treatment and endoscopic cauterization,and briefly descript the factors influencing the efficacy of the treatment of CPSF.