Rhinology and Laryngology Research Fund Fellow, London, UK.
Great Ormond Street Hospital, London, UK.
J Otolaryngol Head Neck Surg. 2020 Dec 11;49(1):82. doi: 10.1186/s40463-020-00475-w.
Pharyngeal arch anomalies are the second most common form of head and neck congenital defect. The second arch anomalies are the most common, and compromise 95% of cases. Little is known about the 3rd and 4th arch anomalies as they are extremely rare. They most commonly present in childhood with sudden severe left lateral neck infection and abscess formation with considerable tendency to recur, contributing to significant mortality and morbidity in those patients.
Here we present four cases finally diagnosed as third or fourth pharyngeal arch anomalies, with more than 20 years of follow-up following their definitive surgery. The possibility that they are thymopharyngeal duct remnants is discussed.
Meticulous open radical surgical excision of all involved paralaryngeal, parapharyngeal and thyroid tissue, with preservation of the superior and recurrent laryngeal nerves, is required for cure of recurrent cases.
咽弓畸形是头颈部先天性缺陷的第二常见形式。第二弓畸形最为常见，占病例的 95%。由于第三和第四咽弓畸形极为罕见，因此对其知之甚少。它们最常发生在儿童期，表现为突然出现严重的左侧颈部感染和脓肿形成，且有相当大的复发倾向，导致这些患者的死亡率和发病率显著增加。
在这里，我们介绍了四个最终诊断为第三或第四咽弓畸形的病例，这些病例在经过明确的手术治疗后进行了 20 多年的随访。讨论了它们可能是胸腺咽管残余物的可能性。
对于复发性病例，需要进行细致的开放性根治性手术切除所有受累的咽旁、咽后和甲状腺组织，并保留喉上神经和迷走神经返支，以达到治愈的目的。
