Laryngoscope-Guided plasma radiofrequency ablation combined with incision/drainage for neonatal congenital pyriform Sinus Fistula with abscess: safety and minimally invasive approach.

内容摘要

To evaluate the clinical safety, efficacy, and recurrence management of a combined surgical approach-neck abscess incision and drainage coupled with low-temperature plasma radiofrequency ablation under laryngoscope-guided suspension laryngoscopy, for neonatal congenital pyriform sinus fistula (CPSF) at the abscess stage. At Hunan Children's Hospital, a retrospective analysis of 21 neonatal abscess-stage CPSF patients was conducted between January 2020 and January 2025. Operative time, blood loss, 24-hour NIPS pain score, vocal cord mobility, NFSS-8 swallowing score, hospital stay, and recurrence rate were the main metrics compared between the simple drainage group (n&#x2009;=&#x2009;7) and the combined surgery group (n&#x2009;=&#x2009;14) based on family request. There were no group differences in baseline variables (gender, gestational age, birth weight, etc.) (all P&#x2009;>&#x2009;0.05). In terms of surgery, the combined group experienced equal blood loss (P&#x2009;=&#x2009;0.068), pain levels (P&#x2009;=&#x2009;0.624), and a longer operating time (P&#x2009;<&#x2009;0.001). A lower NFSS-8 score (11.87&#x2009;&#xb1;&#x2009;2.94 vs. 15.29&#x2009;&#xb1;&#x2009;4.01, P&#x2009;=&#x2009;0.019) and more normal vocal cord movement (92.86% vs. 57.14%, P&#x2009;=&#x2009;0.043) demonstrated greater short-term recovery. Hospital stays were comparable (P&#x2009;=&#x2009;0.781), but the 12-month recurrence rate was lower (7.14% vs. 100%, P&#x2009;=&#x2009;0.002). Combining neck abscess incision and drainage with Plasma Radiofrequency Ablation under Laryngoscope-guided is a safe and efficient treatment for congenital pyriform sinus fistula (CPSF) in neonates with abscess, with acceptable short-term functional recovery and a lower recurrence rate. This minimally invasive approach warrants further investigation in larger prospective, randomized studies.