Holt Anouchka C., Lofgren Daniel H., Hohman Marc H., Shermetaro Carl
Einstein College of Medicine/Montefiore
Vanderbilt University Medical Center
Branchial cleft cysts are congenital anomalies arising from the first through fourth pharyngeal clefts. The most common type of branchial cleft cyst arises from the second cleft, with anomalies derived from the first, third, and fourth clefts being rarer. As this is a congenital anomaly, brachial cleft cysts are present at birth, although they may not be obvious or symptomatic until later. The majority of lesions present in childhood as a visible punctum on the skin of the anterior neck with or without periodic drainage; however, they may present as a neck mass or as recurrent abscesses due to infections within the tract. Branchial cleft anomalies occur in 1 of 3 forms: cysts, sinuses, or fistulae. Cysts are epithelial-lined structures that do not have external openings that connect to the skin or pharynx, and as such, may be asymptomatic and only noticed incidentally. Such cysts may not present until adulthood. Sinus tracts connect either the skin or the pharynx to a blind pouch. Sinus tracts may communicate externally with skin as a visible punctum or internally with the pharynx or larynx, where the punctum opening will only be visible on endoscopy. Branchial cleft fistulae are true communications connecting the pharynx or larynx with the external skin.
鳃裂囊肿是源于第一至第四鳃裂的先天性异常。最常见的鳃裂囊肿类型源于第二鳃裂，源于第一、第三和第四鳃裂的异常则较为罕见。由于这是一种先天性异常，在出生时就已存在，不过可能直到后来才会明显或出现症状。大多数病变在儿童期表现为皮肤上可见的小孔，尽管它们也可能表现为囊肿或颈部肿块，偶尔会被误诊为颈部脓肿。鳃裂异常以三种形式之一出现：囊肿、窦道或瘘管。囊肿有上皮内衬且无外部开口，因此可能无症状，仅偶然被发现。此类囊肿可能直到成年才会出现。窦道可能外部与皮肤相通形成可见的小孔，或内部与咽或喉相通，其点状开口仅在内镜检查时可见。鳃裂瘘管是连接咽或喉与外部皮肤的真正通道。
