Department of Radiology, Saitama Children's Medical Center, Saitama, Japan.
Department of Surgery, Saitama Children's Medical Center, Saitama, Japan.
Am J Otolaryngol. 2021 Jan-Feb;42(1):102783. doi: 10.1016/j.amjoto.2020.102783. Epub 2020 Oct 23.
In neonates, pyriform sinus fistulas and lymphangiomas require different early treatment, such as surgical resection or sclerosing therapy, respectively. We aimed to evaluate the use of sonographic findings for differentiating between pyriform sinus fistulas and lymphangiomas in neonates with a lateral cervical cystic mass.
Sixteen cases diagnosed with pyriform sinus fistulas (n = 7) or lymphangiomas (n = 9) were included. Sonographic findings, including fistulas from the pyriform sinus, air-containing cysts, abnormal thyroid parenchyma echogenicity, internal septae within the cyst and spread to the opposite cervical site, were compared between neonates with pyriform sinus fistulas and those with lymphangiomas. Fisher's exact was used for statistical comparisons.
A significant difference was observed between cases with and without air-containing cysts (present/absent in neonate with pyriform sinus fistula vs lymphangioma: 5/2 vs. 0/9; p = 0.005), abnormal thyroid parenchyma echogenicity (present/absent: 4/3 vs. 0/9; p = 0.019), and internal septae within the cysts (present/absent: 2/7 vs. 9/9; p = 0.005). No significant differences were observed between cases with or without a fistula from the pyriform sinus (present/absent: 2/5 vs. 9/0; p = 0.175) and spread to the opposite cervical site (present/absent: 4/3 vs. 4/5; p = 0.500).
Ultrasound can differentiate pyriform sinus fistulas from lymphangiomas in neonates. In our small cohort, if they exhibited the respective sonographic findings; fistula from pyriform sinus, air-containing cysts or abnormal thyroid parenchyma echogenicity, patients were diagnosed as cases of pyriform sinus fistula. These diagnoses are critical for pediatric surgeons or otolaryngologists in surgical planning.
在新生儿中，梨状窝瘘和淋巴管瘤需要不同的早期治疗，分别为手术切除或硬化治疗。我们旨在评估超声检查在鉴别新生儿侧颈部囊性肿块的梨状窝瘘和淋巴管瘤中的作用。
纳入 16 例诊断为梨状窝瘘（n=7）或淋巴管瘤（n=9）的病例。比较梨状窝瘘和淋巴管瘤新生儿的超声表现，包括来自梨状窝的瘘管、含气囊肿、甲状腺实质回声异常、囊肿内的内部隔膜以及向对侧颈部扩散。Fisher 确切概率法用于统计学比较。
有气囊肿和无气囊肿的病例之间存在显著差异（梨状窝瘘新生儿中有/无气囊肿：5/2 比 0/9；p=0.005），甲状腺实质回声异常（有/无：4/3 比 0/9；p=0.019），以及囊肿内的内部隔膜（有/无：2/7 比 9/9；p=0.005）。来自梨状窝的瘘管和向对侧颈部扩散的病例之间无显著差异（有/无：2/5 比 9/0；p=0.175）和 （有/无：4/3 比 4/5；p=0.500）。
超声可在新生儿中区分梨状窝瘘和淋巴管瘤。在我们的小队列中，如果出现相应的超声表现；即来自梨状窝的瘘管、含气囊肿或甲状腺实质回声异常，患者被诊断为梨状窝瘘。这些诊断对小儿外科医生或耳鼻喉科医生的手术计划至关重要。
