Diagnosis and management of pyriform sinus cyst in neonates: 16-year experience at a single center

Background/purpose: The purpose of this study was to review our experience in diagnosing and managing neonatal pyriform sinus cyst (PSC) and to assess its outcomes. Methods: We retrospectively reviewed 38 cases of neonatal PSC from 2001 to 2016. Clinical features, PSC diagnosis, treatment, and outcomes were analyzed. Results: Cervical masses were detected prenatally in 8 patients (21.1%). Neck cyst and respiratory distress were frequent symptoms among these patients. Preoperative PSC diagnosis was made in 15 cases (39.5%) by esophagography. CT or MRI images showed an air-filled cyst in 22 patients (57.9%). Cyst drainage was performed in 8 infected cases (21.1%). Cyst and fistula excision was performed in 30 cases (78.9%). Fistula excision assisted by endoscopy was required in 13 PSC patients (34.2%). Fistula detection failed in 4 cases (10.5%). Patients aged between 0 to 7 days presented with low infection and high cyst removal rate. No fistula recurrence occurred in cases with cyst resection. Conclusions: CT or MRI images with an air-filled cyst are significant indications in diagnosing PSC. Surgical options for PSC depend on levels of cervical infection. The optimal timing for surgical intervention is between 0 to 7 days after birth. Our surgical approaches were effective in treating neonatal PSC. (C) 2017 Elsevier Inc. All rights reserved.