Stokroos R J, Manni J J
Department of Otorhinolaryngology-Head Neck Surgery, University Hospital Maastricht, The Netherlands.
Am J Otol. 2000 Nov;21(6):837-41.
To discuss the embryology, classification, clinical experience with, and management of first branchial cleft anomalies.
Retrospective case review.
Tertiary referral center.
Patients with a first branchial cleft anomaly.
Surgery or revision surgery.
Classifications according to Work, Olsen, Chilla; previous diagnostic and therapeutic pitfalls; outcome of intervention (including facial nerve function).
Between 1984 and 1999, first branchial cleft anomalies were diagnosed in 18 patients. Surgical treatment was the treatment of choice. The authors' approach in Work type I and type 2 lesions is described, and surgical aspects of revision surgery are discussed. The importance of early establishment of the relationship of the anomaly to the facial nerve is stressed. In 8 patients, previous surgical attempts had been undertaken without establishment of the diagnosis first. After intervention, the outcome was favorable.
First branchial cleft anomalies occur sporadically in ordinary clinical practice. They may go unrecognized or may be mistaken for tumors or other inflammatory lesions of in the periauricular region. However, the distinct clinical features, which can be derived from embryologic development, usually lead to the correct diagnosis. This avoids both treatment delay and eventual failure.
探讨第一鳃裂畸形的胚胎学、分类、临床经验及治疗方法。
回顾性病例分析。
三级转诊中心。
第一鳃裂畸形患者。
手术或修复手术。
根据Work、Olsen、Chilla分类法进行分类；既往诊断和治疗中的失误；干预效果（包括面神经功能）。
1984年至1999年间，18例患者被诊断为第一鳃裂畸形。手术治疗是首选治疗方法。描述了作者对Work I型和II型病变的处理方法，并讨论了修复手术的手术要点。强调了早期明确畸形与面神经关系的重要性。8例患者此前未经明确诊断就进行了手术。干预后，效果良好。
第一鳃裂畸形在普通临床实践中偶有发生。它们可能未被识别，或被误诊为耳周区域的肿瘤或其他炎性病变。然而，源于胚胎发育的独特临床特征通常可导致正确诊断。这既能避免治疗延误，又能防止最终治疗失败。
