Pereira Kevin D, Losh Garrett G, Oliver Dwight, Poole Michael D
Department of Otolaryngology, Head and Neck Surgery, Houston Medical School, University of Texas, 6431 Fannin, Suite 6.112, Houston, TX 77030, USA.
Int J Pediatr Otorhinolaryngol. 2004 Jan;68(1):43-50. doi: 10.1016/j.ijporl.2003.09.004.
Third and fourth branchial pouch anomalies are rare and usually present as lateral neck masses, abscesses or with acute suppurative thyroiditis. An opening in the piriform sinus can be identified in most cases. We present four cases of fourth branchial pouch sinuses, one of a third branchial cyst and discuss our management. Cannulation of the sinus tract at laryngoscopy, followed by complete surgical excision, via a modified oblique thyrotomy above the cricothyroid joint after detaching the inferior constrictor was used to treat the fourth branchial pouch anomalies. This surgical approach adequately exposes the piriform sinus apex and also affords protection to the recurrent laryngeal nerve. The third pouch cyst and tract were excised at the level of the thyrohyoid membrane. There were no complications or recurrences.
第三和第四鳃裂异常较为罕见，通常表现为颈部外侧肿块、脓肿或急性化脓性甲状腺炎。大多数情况下可发现梨状窦有开口。我们报告了4例第四鳃裂窦病例、1例第三鳃裂囊肿病例，并讨论了我们的治疗方法。通过在喉镜下对窦道进行插管，然后在分离咽下缩肌后，经甲状软骨膜上方改良斜行甲状腺切开术进行完整的手术切除，以治疗第四鳃裂异常。这种手术方法能充分暴露梨状窦尖部，同时也能保护喉返神经。第三鳃裂囊肿和窦道在甲状舌骨膜水平切除。无并发症或复发情况。
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