The endoscopic and surgical management of pyriform sinus fistulae in infants and children.

Congenital pyriform sinus fistula, an embryonic remnant of the third pharyngeal pouch, is a newly recognized entity that leads to acute cervical abscess. Nine cases were reported, in patients ranging from 0 to 15 years old. In all but one case, the fistula occurred on the left side. Prior to surgery, the patients were subjected to microlaryngoscopy to identify an internal orifice and to leave a Fogarty catheter in place. Subsequent surgical ligation of the fistula was performed with this catheter as a guide. In patients with repeated infection, such a technique is mandatory for the success of surgery.