Zhu Ting, Hua Qingquan
Department of Otolaryngology-Head and Neck Surgery, People's Hospital of Wuhan University, Wuhan, 430060, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Nov;25(22):1027-9.
To explore diagnosis and surgical operation through analyzing clinical features of the fourth branchial cleft anomalies.
Clinical materials of 10 patients with the fourth branchial cleft anomalies were retrospectively analyzed, and literatures were studied to explore the diagnosis, differential diagnosis and treatment methods of surgical operation; lesions of 10 patients were completely removed by surgical operation, and internal sinus was properly handled.
All 10 cases were cured, no recurrence were observed during a follow-up of 1-3 years. 1 patient appeared low voice, and drinking cough, back to normality after 2 weeks; 1 patient appeared paralysis of left hypoglossal nerves, back to normality after 3 months.
Recurrent deep neck abscess and chronic sinus infections of anterior area in the lower part of neck should be considered with the diagnosis of the fourth branchial cleft anomalies. Enhanced neck CT scan and barium sulfate meal examination aid to diagnosis, pathological examination can be confirmed. Complete surgical removal of lesions is an effective treatment of fourth branchial cleft anomalies, knowing of the courses of internal sinus and spread of infection, and use of principle of selective neck dissection is the key to ensure complete removal of lesions.
通过分析第四鳃裂畸形的临床特征，探讨其诊断及外科手术方法。
回顾性分析10例第四鳃裂畸形患者的临床资料，并查阅文献，探讨其诊断、鉴别诊断及外科手术治疗方法；对10例患者的病变行手术完整切除，并妥善处理内瘘。
10例患者均治愈，随访1～3年无复发。1例患者出现声音低沉及饮水呛咳，2周后恢复正常；1例患者出现左侧舌下神经麻痹，3个月后恢复正常。
对于反复发生的颈部深部脓肿及颈部下方前部区域的慢性窦道感染，应考虑第四鳃裂畸形的诊断。颈部增强CT扫描及硫酸钡餐检查有助于诊断，病理检查可确诊。手术完整切除病变是治疗第四鳃裂畸形的有效方法，了解内瘘走行及感染扩散情况，采用选择性颈清扫原则是确保病变完整切除的关键。
