Jordan J A, Graves J E, Manning S C, McClay J E, Biavati M J
Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas 75235-9035, USA.
Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):1021-4. doi: 10.1001/archotol.124.9.1021.
Fourth branchial cleft sinuses are rare, and the nature of their origin is controversial. Clinical presentation is varied because they may present as asymptomatic neck masses, recurrent neck abscesses, or suppurative thyroiditis. We describe herein 7 children who presented with abscesses on the left side of their necks, 3 of whom had abscesses that involved the thyroid gland. Direct laryngoscopy revealed that all 7 children had a sinus tract opening into the apex of the piriform sinus. Endoscopic obliteration of this tract was achieved using an insulated electrocautery probe either when the abscess was initially incised and drained or 4 to 6 weeks later. All 7 children recovered uneventfully. Four of the 7 children were followed up for more than 18 months without recurrence.
第四鳃裂窦道罕见，其起源性质存在争议。临床表现多样，因为它们可能表现为无症状的颈部肿块、复发性颈部脓肿或化脓性甲状腺炎。我们在此描述7例左侧颈部出现脓肿的儿童，其中3例脓肿累及甲状腺。直接喉镜检查显示，所有7例儿童均有一个窦道开口于梨状窝尖部。当脓肿最初切开引流时或4至6周后，使用绝缘电灼探头对该窦道进行内镜下闭塞。所有7例儿童均顺利康复。7例儿童中有4例随访超过18个月无复发。
