Chen Liangsi, Huang Xiaoming, Lou Xiaonin, Xhang Siyi, Song Xinhan, Lu Zhongming, Xu Mimi
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Nov;27(22):1258-62.
To assess the feasibility, risks and advantages of endoscope-assisted second branchial cleft cyst (SBCC) resection via the retroauricular hairline approach (RHA) by comparing with conventional trans cervical approach.
Using prospective clinical controlled study, in twenty five patients with SBCC, 13 cases underwent endoscope-assisted resection via the RHA, 12 cases underwent conventional transcervical approach resection. Preoperatively, the sizes, locations and adjacency of all lesions were evaluated by ultrasonography, CT or MRI. Pathologic diagnoses of all cases were identified as SBCC using fine needle aspiration biopsy. Two groups were compared at length of incision, operation time, bleeding, incision cosmetic result, complication etc.
All 25 operations were successfully performed. Length of incision and operation time in endoscopic group were significantly longer than that of the transcervical group (P < 0.05). After three months, the mean subjective satisfaction score of incision scar in the endoscopic group was significantly higher than that of transcervical group (P < 0.01). In endoscopic group, 1 cases (7.7%) with temporary numbness of earlobe and 1 case (7.7%) with a darkened color change of the flap margin at the incision angle were found postoperatively. However, they were recovered within 1 month. All the 25 patients were disease free with a follow-up from 18 to 36 months (median follow-up: 26 months).
Endoscope-assisted SBCC resection via RHA is feasible and safe for the treatment of SBCC. In comparison with the transcervical approach, this method can provide an invisible incision and better cosmetic re suits without significant complications.
通过与传统经颈入路比较,评估经耳后发际入路(RHA)在内镜辅助下切除第二鳃裂囊肿(SBCC)的可行性、风险及优势。
采用前瞻性临床对照研究,25例SBCC患者中,13例行经耳后发际入路的内镜辅助切除术,12例行传统经颈入路切除术。术前通过超声、CT或MRI评估所有病变的大小、位置及毗邻关系。所有病例均采用细针穿刺活检病理诊断为SBCC。比较两组的切口长度、手术时间、出血量、切口美容效果、并发症等。
25例手术均顺利完成。内镜组的切口长度和手术时间显著长于经颈组(P<0.05)。3个月后,内镜组切口瘢痕的平均主观满意度评分显著高于经颈组(P<0.01)。内镜组术后发现1例(7.7%)耳垂暂时麻木,1例(7.7%)切口角皮瓣边缘颜色变深,但均在1个月内恢复。25例患者随访18至36个月(中位随访:26个月),均无疾病复发。
经耳后发际入路在内镜辅助下切除SBCC治疗SBCC是可行且安全的。与经颈入路相比,该方法可提供隐蔽的切口,美容效果更佳,且无明显并发症。