ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Otolaryngology
Long-Term Outcomes of Endoscopic Radiofrequency Ablation for Pyriform Sinus Fistula in Children and Risk Factors for Transient Vocal Cord Paralysis
Provisionally accepted
- 1Department of Otolaryngology, Shanxi Provincial Children's Hospital, Taiyuan, China
- 2Shanxi Medical University, Taiyuan, China
- 3Department of Neonatal Surgery, Shanxi Provincial Children's Hospital, Taiyuan, China
- 4First Hospital of Shanxi Medical University, Taiyuan, China
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Objectives: To evaluate the long-term efficacy and safety of endoscopic low-temperature plasma radiofrequency ablation (coblation) for the treatment of pyriform sinus fistula (PSF) in children, and to identify risk factors associated with postoperative transient vocal cord paralysis. Methods: A retrospective cohort study was conducted at a single tertiary pediatric center. Children with pyriform sinus fistula who underwent endoscopic coblation were consecutively enrolled. Demographic characteristics, perioperative variables, postoperative complications, and follow-up outcomes were collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for postoperative transient vocal cord paralysis. Results: Endoscopic coblation was successfully performed in all patients. During follow-up, the majority of children experienced no recurrent cervical infection or fistula recurrence. Endoscopic examinations confirmed complete closure of the internal opening in the pyriform sinus, indicating favorable long-term outcomes and good procedural reproducibility. Transient vocal cord paralysis occurred in some patients but resolved completely in all affected cases, with no permanent nerve injury. Multivariate logistic regression analysis identified younger age and elevated preoperative white blood cell counts as independent risk factors for transient vocal cord paralysis. Conclusions: Endoscopic coblation is a safe, effective, and repeatable minimally invasive treatment for pediatric PSF, with low recurrence rates and stable long-term outcomes. Postoperative transient vocal cord paralysis is a relatively common but reversible complication, closely associated with younger age and elevated preoperative inflammatory status. These risk factors suggest that intraoperative strategies, such as adjusting ablation depth in very young children and ensuring adequate thermal dissipation, may help mitigate this risk.
Keywords: Endoscopic coblation, minimally invasive surgery, Pyriform sinus fistula, Risk factors, Vocal Cord Paralysis
Received: 23 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Niu, Li, Chai and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangbin Chai
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