Zhang B, Chen L S, Huang S L, Liang L, Wu P N, Zhang S Y, L Z M, Liang L
Southern Medical University,Guangzhou,510515,China.
Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Sep 5;30(17):1359-1362. doi: 10.13201/j.issn.1001-1781.2016.17.005.
To sum up and conclude manifestation of congenital first branchial anomaly(CFBCA).The clinical data of 56 patients from 2005 to 2015 in our hospital were retrospective reviewed.Manifestation:mass without pain(26.8%),repeated sore and discharge(71.4%),otological symptom(external auditory discharge､hearing loss,28.6%).Eleven cases bacterial sample showed positive result,and most of them show pseudomonas aeruginosa and staphylococcus aureus.Auricular endoscopy typically performed stricture of external auditory canal,cholesteatoma samples accumulated in ear canal,fistula at the conjunction of the bone and cartilage and tympanic membranous attachment.Typical performance of CT(MRI)was that there were cystic,lobulated or tubular abnormal shadow related with ear canal in Pochet's triangle area whose cyst wall or pipe wall could been enhanced in enhanced CT(MRI) scans,and part of that could be connected with skin.The statistical difference between type Oslen and Work and clinical characteristics(<0.01),and the relationship between type Oslen and Work(<0.01).Most of Work Ⅰ were cyst type,and these two type often had no infected symptom.Most of them were young patients.Most of Work Ⅱ were sinus and fistula type ,and these two type often had infected symptom.Most of them were teenagers.Part of patients of type Work Ⅱ showed tympanic membranous attachment.CFBCA was rare,and it is more common in young patients and often in left part.It always performed as mass without pain､repeated sore and discharge､external auditory discharge.Most of Work Ⅰ were cyst type,and these two type often had no infected symptom and most of them were young patients .Most of Work Ⅱ were sinus and fistula type,and these two type often had infected symptom and most of them were teenagers.Auricular endoscopy,CT,MRI could help make diagnose.Doctors clinical need to differentiate it with related diseases according to different manifestations.
总结先天性第一鳃裂畸形（CFBCA）的表现。回顾性分析我院2005年至2015年56例患者的临床资料。表现：无痛性肿块（26.8%）、反复肿痛及流脓（71.4%）、耳部症状（外耳道流脓、听力下降，28.6%）。11例细菌培养样本呈阳性结果，其中大部分为铜绿假单胞菌和金黄色葡萄球菌。耳内镜检查典型表现为外耳道狭窄、胆脂瘤样物积聚于耳道、骨与软骨交界处及鼓膜附着处瘘管形成。CT（MRI）典型表现为Pochet三角区与耳道相关的囊性、分叶状或管状异常影，增强CT（MRI）扫描时囊壁或管壁可强化，部分可与皮肤相连。Oslen型与Work型之间的统计学差异及临床特征（<0.01），以及Oslen型与Work型之间的关系（<0.01）。WorkⅠ型大多为囊肿型，这两型通常无感染症状。大多为年轻患者。WorkⅡ型大多为窦道和瘘管型，这两型通常有感染症状。大多为青少年。部分WorkⅡ型患者可见鼓膜附着。CFBCA罕见，多见于年轻患者，且常发生于左侧。常表现为无痛性肿块、反复肿痛及流脓、外耳道流脓。WorkⅠ型大多为囊肿型，这两型通常无感染症状，大多为年轻患者。WorkⅡ型大多为窦道和瘘管型，这两型通常有感染症状，大多为青少年。耳内镜、CT、MRI有助于诊断。医生临床需根据不同表现与相关疾病进行鉴别。
