Takimoto T, Yoshizaki T, Ohoka H, Sakashita H
Department of Otolaryngology, School of Medicine, Kanazawa University, Japan.
J Laryngol Otol. 1990 Nov;104(11):905-7. doi: 10.1017/s002221510011432x.
We present an extremely rare case of fourth branchial fistula in a 23-year-old male. The characteristic clinical feature was a recurrent left lower neck abscess which did not respond to appropriate medical and surgical therapy. Radiography and a computed tomographic scan with contrast material revealed a fistula running from the apex of the left pyriform sinus (internal opening) to the left lower neck abscess. The fistula tract was excised surgically. Histological examination of the excised fistula revealed a squamous epithelial lining and subepithelial lymphoid tissue. This pyriform sinus fistula is thought to be of fourth pharyngeal pouch origin, because of its surgical aspects and the histological findings of the excised fistula.
我们报告了一例极为罕见的23岁男性第四鳃裂瘘管病例。其特征性临床症状为左颈部下方反复出现脓肿，对适当的内科及外科治疗均无反应。X线造影及增强计算机断层扫描显示，瘘管从左梨状窝尖部（内口）延伸至左颈部下方脓肿处。通过手术切除了瘘管。对切除的瘘管进行组织学检查发现，其内衬鳞状上皮，上皮下有淋巴组织。鉴于其手术表现及切除瘘管的组织学检查结果，此梨状窝瘘管被认为起源于第四咽囊。
