Zhao Dongjihui, Li Bin, Zhao Sijun, Huang Min, Liu Guangliang, Zhou Zheng
Department of Otolaryngology Head and Neck Surgery，Hu'nan Children's Hospital，Changsha，410000，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Feb;39(2):137-140;146. doi: 10.13201/j.issn.2096-7993.2025.02.008.
To explore the feasibility of endoscopic-assisted resection of congenital first and second branchial cleft malformations in children via the external fistula incision approach. A retrospective analysis was conducted on 20 children with congenital first and second branchial cleft malformations who were admitted to the Department of Otolaryngology Head and Neck Surgery of Hu'nan Children's Hospital from January 2020 to January 2024 and whose families voluntarily consented to endoscopic surgery. Clinical data were collected. There were 12 males and 8 females, aged from 10 months to 12 years. The surgical methods and experiences of endoscopic-assisted resection of congenital first and second branchial cleft malformations in children via the external fistula incision approach were summarized. All 20 children underwent endoscopic-assisted resection of congenital first and second branchial cleft malformations via the external fistula incision approach. For children with second branchial cleft malformations whose internal fistula openings were located on the pharyngeal arch mucosa or palatine tonsils, the tonsils were preserved, the internal fistula openings were ligated at a high position, the fistula tubes were removed, and the residual ends were cauterized with bipolar electrocoagulation to destroy the residual fistula epithelial cells. There were no obvious complications after the operation. During the 12-month follow-up, no recurrence of the fistula tubeswas observed, and the recovery was good. Congenital first and second branchial cleft fistulas in children are rare, and surgical resection is the preferred treatment method. The endoscopic-assisted resection of congenital first and second branchial cleft malformations in children via the fistula incision approach offers a clear surgical field, an ideal cosmetic effect, and a satisfactory curative effect.
探讨经外瘘口切开入路内镜辅助切除儿童先天性第一、二鳃裂畸形的可行性。对2020年1月至2024年1月在湖南省儿童医院耳鼻咽喉头颈外科住院且家属自愿同意行内镜手术的20例先天性第一、二鳃裂畸形患儿进行回顾性分析。收集临床资料。其中男12例，女8例，年龄10个月至12岁。总结经外瘘口切开入路内镜辅助切除儿童先天性第一、二鳃裂畸形的手术方法及经验。20例患儿均经外瘘口切开入路行内镜辅助切除先天性第一、二鳃裂畸形。对于内瘘口位于咽弓黏膜或腭扁桃体的第二鳃裂畸形患儿，保留扁桃体，高位结扎内瘘口，切除瘘管，残端用双极电凝烧灼，破坏残留瘘管上皮细胞。术后无明显并发症。随访12个月，未见瘘管复发，恢复良好。儿童先天性第一、二鳃裂瘘罕见，手术切除是首选治疗方法。经瘘口切开入路内镜辅助切除儿童先天性第一、二鳃裂畸形手术视野清晰，美容效果理想，疗效满意。
