Endoscopic Radiofrequency Cauterization of Congenital Pyriform Fossa Malformations: Long-Term Outcomes

BACKGROUND: Congenital pyriform fossa malformations (CPFM) are rare types of branchial anomalies. The management approach was previously anatomical, based on outlining the complete surgical excision of the vestige tract. Endoscopic obliteration of the pharyngeal opening of the tract evolved as an alternative to less invasive treatment. Although different techniques have been reported, long-term follow-up data are relatively deficient. METHODS: This is a retrospective analysis of patients with CPFM treated in a tertiary referral hospital. Direct laryngoscopy was the only diagnostic method used. Endoscopic radiofrequency ablation was done as described. Patients with at least 24 months of follow-up were included. RESULTS: Fourteen patients met inclusion criteria, 10 males and 4 females, with a mean age of 8 years. Only one patient had an external cervical component. All patients had the pharyngeal opening in the left pyriform fossa except for one. Average follow-up period was 41.5 months. No complications or recurrences were reported during the follow-up period. CONCLUSION: Endoscopic radiofrequency cauterization can be described as a safe, effective sole treatment of CPFM. The approach we adopted is simple, less demanding with long-term reliability.