Jeyakumar Anita, Hengerer Arthur S
Department of Otolaryngology, University of Rochester, Strong Memorial Hospital, Rochester, NY 14624, USA.
Ear Nose Throat J. 2004 Sep;83(9):640-2, 644.
Embryologic anomalies of the fourth branchial pouch are rarely seen. They usually present as recurring episodes of deep neck infections and/or abscesses or acute suppurative thyroiditis. Failure to recognize these unusual cases may result in misdiagnosis, inadequate treatment, and subsequent recurrence. We report 3 cases of patients with fourth branchial anomalies. Diagnosis starts with a preoperative evaluation consisting of a barium swallow or sonogram followed by direct hypopharyngoscopy at the time of surgery. Treatment of acutely infected sinuses is best done with appropriate antibiotics and, if necessary, with incision and drainage. Surgical excision should be planned after the inflammation has completely resolved.
第四鳃裂的胚胎学异常很少见。它们通常表现为颈部深部感染和/或脓肿或急性化脓性甲状腺炎的反复发作。未能识别这些不寻常的病例可能导致误诊、治疗不充分及随后的复发。我们报告3例第四鳃裂异常患者。诊断始于术前评估，包括吞咽钡剂检查或超声检查，随后在手术时进行直接下咽镜检查。急性感染性窦道的治疗最好使用适当的抗生素，必要时进行切开引流。应在炎症完全消退后计划手术切除。
