Schroeder James W, Mohyuddin Nadia, Maddalozzo John
Division of Pediatric Otolaryngology, Department of Surgery, Children's Memorial Hospital, Northwestern University, Chicago, IL 60614, USA.
Otolaryngol Head Neck Surg. 2007 Aug;137(2):289-95. doi: 10.1016/j.otohns.2007.03.009.
We sought to review the presentation, evaluation, and treatment of branchial anomalies in the pediatric population and to relate these findings to recurrences and complications.
We conducted a retrospective study at a tertiary care pediatric hospital.
Ninety-seven pediatric patients who were treated for branchial anomalies over a 10-year period were reviewed. Patients were studied if they underwent surgical treatment for the branchial anomaly and had 1 year of postoperative follow-up; 67 children met criteria, and 74 anomalies were studied.
Patients with cysts presented at a later age than did those with branchial anomaly fistulas or sinus branchial anomalies. 32% of branchial anomalies were previously infected. Of these, 71% had more than one preoperative infection. 18% of the BA were first arch derivatives, 69% were second arch derivatives and 7% were third arch derivatives. There were 22 branchial cysts, 31 branchial sinuses and 16 branchial fistulas. The preoperative and postoperative diagnoses differed in 17 cases. None of the excised specimens that contained a cystic lining recurred; all five recurrences had multiple preoperative infections.
Recurrence rates are increased when there are multiple preoperative infections and when there is no epithelial lining identified in the specimen.
我们试图回顾儿科人群鳃裂畸形的临床表现、评估和治疗，并将这些发现与复发及并发症相关联。
我们在一家三级儿科医院进行了一项回顾性研究。
回顾了在10年期间接受鳃裂畸形治疗的97例儿科患者。如果患者因鳃裂畸形接受了手术治疗且有1年的术后随访，则纳入研究；67名儿童符合标准，共研究了74处畸形。
囊肿患者的发病年龄比鳃裂瘘或鳃裂窦患者晚。32%的鳃裂畸形既往有感染。其中，71%有不止一次术前感染。18%的鳃裂畸形起源于第一鳃弓，69%起源于第二鳃弓，7%起源于第三鳃弓。有22个鳃裂囊肿、31个鳃裂窦和16个鳃裂瘘。17例患者术前和术后诊断不同。所有含有囊壁的切除标本均未复发；所有5例复发患者术前均有多次感染。
术前有多次感染以及标本中未发现上皮衬里时，复发率会增加。
