Contencin P, Grosskopf-Aumont C, Gilain L, Narcy P
Service d'Otorhinolaryngologie, Hôpital Robert-Debré, Paris.
Arch Fr Pediatr. 1990 Mar;47(3):181-4.
Among the causes of inflammatory swelling of the neck in children, the "cysts" and ducts joining in the hypopharynx deserve being individualized. This unrecognized pathology is indeed responsible for suppurative pseudothyroiditis or cervical abscesses relapsing in spite of adequate antibiotic treatment and incision-drainage. X-ray films may help as they often show the fistula. Diagnosis relies on hypopharyngoscopy. This investigation only may assess the origin of this "internal fistula" by showing the mucous opening of the bottom of the pyriform sinus, from which sometimes springs some pus when pressing the neck. The clear left predominance of this canal and its junction between the superior and inferior laryngeal nerves suggest that its origin could be the 4th branchial pouch. Its treatment consists of complete surgical excision, which avoids relapses.
在儿童颈部炎性肿胀的病因中，下咽处相连的“囊肿”和导管值得单独考虑。这种未被认识的病理状况确实是导致化脓性假甲状腺炎或颈部脓肿的原因，尽管进行了充分的抗生素治疗和切开引流，这些病症仍会复发。X线片可能会有所帮助，因为它们常常能显示瘘管。诊断依赖于下咽镜检查。只有这项检查能够通过显示梨状窦底部的黏膜开口来评估这种“内瘘”的起源，按压颈部时，有时会从这个开口处流出一些脓液。这条管道明显以左侧为主，且位于喉上神经和喉下神经之间，这表明它可能起源于第四鳃囊。其治疗方法是完整的手术切除，这样可避免复发。
