Li Y X, He X G, Wang Y, Yang X
Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital Kunming Medical University,Kunming,650032,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Aug 5;30(15):1201-1205. doi: 10.13201/j.issn.1001-1781.2016.15.006.
To analysize the clinical characteristics as well as the effect and methods of the surgical treatment in patiets with the third and fourth branchial anomalies.The clinical data of 25 patients diagnosed as third and fourth branchial cleft fistula by pathological method were analyzed retrospectively.Two of 25 patients had undergone fistulectomy simply.Based on the embryologicc and anatomic features of branchial anomalies,23 of 25 patients had received different types of selective neck dissection.All of lesions were confirmed as branchial cleft fistula by pathology.All patients were received the examinations of Esophagus myelography,MRI and CT preoperatively.The features of the third and the fourth bianchial fistula were as following:most patients suffered from recurrent neck abscess and had undergone incision and drainage. Esophagus myelography and CT were important auxiliary examination for branchial anomalies.No recurrent and complications were found in all patients by using treatment of selective neck dissection (23/25 cases) and fistulectomy simply(2/25 cases) within 12 to 36 months following-up,postoperatively.Branchial anomalies is characterized by recurrent acute abscess,acute thyroiditis or fistula secretion inferior to neck.Complete removal of branchial lesions and inflammatory granuloma using selective neck dissection is a safty and effective treatment for recurrent branchial anomalies.
分析第三、四鳃裂畸形患者的临床特征以及手术治疗的效果和方法。回顾性分析25例经病理确诊为第三、四鳃裂瘘管的患者的临床资料。25例患者中2例仅行瘘管切除术。根据鳃裂畸形的胚胎学和解剖学特点，25例患者中的23例行不同类型的选择性颈清扫术。所有病变经病理证实为鳃裂瘘管。所有患者术前均接受食管造影、磁共振成像（MRI）和计算机断层扫描（CT）检查。第三、四鳃裂瘘管的特点如下：大多数患者反复出现颈部脓肿并曾行切开引流术。食管造影和CT是鳃裂畸形的重要辅助检查。术后随访12至36个月，采用选择性颈清扫术（23/25例）和单纯瘘管切除术（2/25例）治疗的所有患者均未出现复发及并发症。鳃裂畸形的特点是反复出现急性脓肿、急性甲状腺炎或颈部下方有瘘管分泌物。采用选择性颈清扫术彻底切除鳃裂病变及炎性肉芽肿是治疗复发性鳃裂畸形安全有效的方法。
