Chemocauterization of the internal opening with trichloroacetic acid as first-line treatment for pyriform sinus fistula

Background. Pyriform sinus fistula is a rare brachial pouch anomaly. However, it is difficult and risky to remove the fistula tract completely. Circumferential chemocauterization of the internal opening with trichloroacetic acid (TCA) for pyriform sinus fistula is simple, reproducible, reliable, and causes less morbidity. The aim of this study was to determine the feasibility of TCA chemocauterization for pyriform sinus fistula. Methods. This retrospective study enrolled 44 patients who were diagnosed with pyriform sinus fistula and underwent TCA chemocauterization. We retrospectively reviewed the medical records of the patients to obtain their demography as well as treatment outcomes for them. Results. The success rate of treatment for pyriform sinus fistula after the first TCA chemocauterization was 77.3% (34/44) and the cumulative success rate after the second treatment was 93.2% (41/44). There was no complication such as vocal fold palsy after TCA chemocauterization. Conclusions. It is suggested that TCA chemocauterization can be a reasonable first-line treatment for pyriform sinus fistula. (C) 2012 Wiley Periodicals, Inc. Head Neck 35: 431-435, 2013