Hu Yong-Jie, Li Ya-Dong, Qu Xing-Zhou, Wang Li-Zhen, Zhong Lai-Ping, Liu Liu, Zhang Chen-Ping
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
Shanghai Kou Qiang Yi Xue. 2008 Oct;17(5):461-4.
To investigate the clinical manifestation of branchial cleft cyst (fistula) and provide some clinical experience on its diagnosis and treatment.
From June 1993 to December 2006, two hundred and eighty-four patients with branchial cleft cyst or fistula underwent surgical treatment were retrospectively reviewed, the preoperative examinations, preoperative diagnosis and postoperative pathological diagnosis were recorded, and the data was analyzed with SAS6.12 software package.
Among the 284 patients with branchial cleft cyst or fistula confirmed by postoperative pathological diagnosis, there were 132 patients (46.5%) with first branchial cleft cyst or fistula, one hundred and forty-five patients (51.1%) with second branchial cleft cyst or fistula, and 7 patients (2.4%) with third branchial cleft cyst or fistula. First branchial cleft cyst or fistula often occurred in patients older than 40 years, second and third branchial cleft cyst or fistula often occurred in patients younger than 40 years. The pathological diagnosis confirmed 188 primary lesions, thirty-three recurrent lesions, forty-four lesions with internal fistula, fourteen lesions with secondary infection and external fistula, and three lesions with both internal and external fistulae. One patient was found with tuberculosis simultaneously, two patients with multiple cysts, one patient with venous malformation. Six lesions were found malignant, five from first branchial cleft and one from second branchial cleft. The highest accuracy of preoperative diagnosis was 66.20% using ultrasonography. During the follow-up period, 5.98% of patients had recurrence.
First and second branchial cleft cysts (fistula) are the most common lesions. Preoperative ultrasonography is the first choice for diagnosis of branchial cleft cyst (fistula). Complete resection including the cyst and fistula is the key to successful surgical treatment. Supported by Shanghai Leading Academic Discipline Project (Grant No.Y0203).
探讨鳃裂囊肿（瘘管）的临床表现，为其诊断及治疗提供临床经验。
回顾性分析1993年6月至2006年12月期间接受手术治疗的284例鳃裂囊肿或瘘管患者，记录其术前检查、术前诊断及术后病理诊断情况，采用SAS6.12软件包对数据进行分析。
术后病理诊断确诊的284例鳃裂囊肿或瘘管患者中，第一鳃裂囊肿或瘘管132例（46.5%），第二鳃裂囊肿或瘘管145例（51.1%），第三鳃裂囊肿或瘘管7例（2.4%）。第一鳃裂囊肿或瘘管多见于40岁以上患者，第二、三鳃裂囊肿或瘘管多见于40岁以下患者。病理诊断证实原发性病变188例，复发性病变33例，伴有内瘘的病变44例，伴有继发感染及外瘘的病变14例，同时伴有内、外瘘的病变3例。发现1例患者同时合并结核，2例患者有多发性囊肿，1例患者有静脉畸形。发现6例病变为恶性，其中5例来自第一鳃裂，1例来自第二鳃裂。术前超声诊断的最高准确率为66.20%。随访期间，5.98%的患者出现复发。
第一、二鳃裂囊肿（瘘管）是最常见的病变。术前超声检查是诊断鳃裂囊肿（瘘管）的首选方法。完整切除囊肿及瘘管是手术成功治疗的关键。由上海重点学科项目资助（项目编号：Y0203）。
