Ertas Burak, Gunaydin Rıza Onder, Unal Omer Faruk
Department of Otorhinolaryngology, Acibadem University, Medical School, Maslak, Istanbul, Turkey.
Department of Otorhinolaryngology, Hacettepe University, Medical School, Sihhiye, Ankara, Turkey.
Auris Nasus Larynx. 2015 Apr;42(2):119-22. doi: 10.1016/j.anl.2014.08.017. Epub 2014 Sep 16.
To share our experience involving seven patients with type II first branchial cleft anomalies (hereafter, type II anomalies), to determine whether the location of the external fistula openings of the anomalies are associated with the location of the facial nerve tract, and elucidate the relationship between the location of the fistula opening and the facial nerve.
The medical records of seven patients who underwent surgery from 2005 to 2013 for type II anomalies were retrospectively examined. The relationship between the fistula opening and the facial nerve was evaluated in each patient with respect to whether the fistula opening was superior or inferior to the mandibular angle. All patients underwent partial parotidectomy, facial nerve exposure, and total excision of the mass together with connection of a small cuff of the external auditory canal skin to the fistula tract.
The fistula tracts were located medially to the facial nerve in two patients, and both fistulae had openings inferior to the mandibular angle. The fistula tracts were located laterally to the facial nerve in the remaining five patients: one patient had no external opening, one had an opening inferior to the mandibular angle, and the remaining three had openings superior to the mandibular angle.
Because type II anomalies are rare, their diagnosis is difficult. Surgery of such lesions is challenging and associated with a high risk due to their proximity to the facial nerve. We believe that the location of the fistula opening may help to identify the relationship between the anomalous lesion and facial nerve. Studies involving larger series of cases are needed to confirm our hypothesis; however, because of the rarity of this specific anomaly, it will not be easy to compile a large number of cases. We believe that our study will encourage further investigation on this subject.
分享我们诊治7例II型第一鳃裂畸形（以下简称II型畸形）患者的经验，确定畸形外瘘口的位置是否与面神经走行位置相关，并阐明瘘口位置与面神经之间的关系。
回顾性分析2005年至2013年接受手术治疗的7例II型畸形患者的病历。评估每位患者瘘口与面神经的关系，即瘘口位于下颌角上方还是下方。所有患者均接受了部分腮腺切除术、面神经暴露以及肿物全切，并将外耳道皮肤一小段袖口样组织与瘘管相连。
2例患者的瘘管位于面神经内侧，且两个瘘口均位于下颌角下方。其余5例患者的瘘管位于面神经外侧：1例患者无外瘘口，1例患者的瘘口位于下颌角下方，其余3例患者的瘘口位于下颌角上方。
由于II型畸形罕见，其诊断困难。此类病变的手术具有挑战性，且因其靠近面神经而风险较高。我们认为瘘口位置可能有助于确定异常病变与面神经之间的关系。需要开展涉及更大病例系列的研究来证实我们的假设；然而，鉴于这种特定畸形的罕见性，收集大量病例并非易事。我们相信我们的研究将鼓励对此主题进行进一步研究。
