Zhou Yilong, Chen Wei, Xu Rong, Chen Jiarui, Li Xiaoyan
Department of Children Otorhinolaryngology，Shenzhen Hospital，Southern Medical University，Shenzhen，518000，China.
Department of Otolaryngology Head and Neck Surgery，Shanghai Children's Hospital，School of Medicine，Shanghai Jiao tong University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jun;36(6):441-447. doi: 10.13201/j.issn.2096-7993.2022.06.007.
To summarize the CT features of congenital branchial cleft anomaly in children, to reduce misdiagnosis and improve surgical strategy. This study enrolled 323 pediatric patients with congenital first branchial cleft anomaly, congenital second branchial cleft anomaly and congenital piriform sinus fistula confirmed by surgery and post-operative histopathology, who was admitted to Shanghai Children's hospital from August 2014 to January 2021., CT imaging data were retrospectively analyzed. A total of 323 children with congenital branchial cleft deformity were included. There were 145 males and 178 females, aged from 22 days to 15 years. 119（119/323, 36.8%） cases were diagnosed as congenital first branchial cleft anomaly. Among them, 96 cases（96/119, 80.67%） were related to the wall of external auditory canal, and 89 cases（89/119, 74.78%） were related to parotid gland. The positive rate of CT examination was 87.4%（104/119）. 57 cases（57 / 323, 17.6%） had congenital second branchial cleft anomaly. Among them, 46 cases（46/57, 80.7%） were related to submandibular gland. The positive rate of CT examination was 84.2%（48/57）. 147 cases（147/323, 45.5%） had congenital piriform sinus fistula, in which 129 cases（129/147, 87.8%） were related to thyroid. The positive rate of CT was 89.1%（131/147）. The CT findings of congenital first branchial cleft anomaly are characterized by lesions in the inferior and/or posterior wall of ipsilateral external auditory canal and parotid gland. The CT features of congenital second branchial cleft anomaly are that the lesion is located on the ipsilateral submandibular gland （posterior and medial）. The CT features of congenital piriform sinus fistula are that the focus is located on the dorsal side of the upper pole of the lateral lobe of the thyroid gland.
总结儿童先天性鳃裂畸形的CT特征，减少误诊并改进手术策略。本研究纳入了2014年8月至2021年1月期间在上海儿童医学中心收治的323例经手术及术后病理证实的先天性第一鳃裂畸形、先天性第二鳃裂畸形和先天性梨状窝瘘的儿科患者，对其CT影像资料进行回顾性分析。共纳入323例先天性鳃裂畸形患儿，其中男性145例，女性178例，年龄22天至15岁。119例（119/323，36.8%）诊断为先天性第一鳃裂畸形，其中96例（96/119，80.67%）与外耳道壁有关，89例（89/119，74.78%）与腮腺有关，CT检查阳性率为87.4%（104/119）。57例（57/323，17.6%）为先天性第二鳃裂畸形，其中46例（46/57，80.7%）与下颌下腺有关，CT检查阳性率为84.2%（48/57）。147例（147/323，45.5%）为先天性梨状窝瘘，其中129例（129/147，87.8%）与甲状腺有关，CT阳性率为89.1%（131/147）。先天性第一鳃裂畸形的CT表现为同侧外耳道下壁和/或后壁及腮腺内病变；先天性第二鳃裂畸形的CT特征为病变位于同侧下颌下腺（后方及内侧）；先天性梨状窝瘘的CT特征为病灶位于甲状腺侧叶上极背侧。
