山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (3): 61-64.doi: 10.6040/j.issn.1673-3770.0.2016.041

• 论著 • 上一篇    下一篇

第三腮裂瘘管诊治6例并文献复习

李清明,吴思恩,黄素红,曹火太,黄穗华,姚婷婷,刘其洪   

  1. 深圳市第四人民医院耳鼻咽喉头颈外科, 广东 深圳 518033
  • 收稿日期:2016-01-27 出版日期:2016-06-16 发布日期:2016-06-16
  • 作者简介:李清明. E-mail:2596990858@qq.com

Diagnosis and treatment of the third branchial cleft fistula: a clinical report of 6 cases and literature review.

LI Qingming, WU Sien, HUANG Suhong, CAO Huotai, HUANG Suihua, YAO Tingting, LIU Qihong   

  1. Department of Otolaryngology &Head and Neck Surgery, Fourth Peoples Hospital of Shenzhen, Shenzhen 518033, Guangdong, China
  • Received:2016-01-27 Online:2016-06-16 Published:2016-06-16

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摘要： 目的 探讨第三腮裂瘘管的临床特征及治疗方法。 方法 回顾性分析6例第三腮裂瘘管患者的临床资料,包括术前检查、手术治疗过程及疗效,并复习相关文献。行多层螺旋CT及瘘管碘造影剂造影,能显示瘘管走行及内瘘口位于梨状窝,全麻下应用功能性颈清扫术式彻底切除瘘管,术后切口一期愈合。 结果 6例中误诊3例,包括颈部脓肿2例、亚急性甲状腺炎1例。随访10个月以上无复发。 结论 多层螺旋CT及瘘管碘造影剂造影可显示瘘管全程,诊断准确、简便,为彻底切除病变提供安全保障。功能性颈清扫术能切除瘘管全程,是一种安全、有效的治疗手段。

关键词: 误诊, 腮裂瘘管, 梨状窝, 功能性颈清扫术

Abstract: Objective To investigate the clinical characteristics, diagnosis and therapy of the third branchial cleft fistula. Methods Clinical data of 6 cases of third barnchial cleft fistula were retrospectively reviewed, and related literatures were reviewed. Multi-slice spiral computerized tomography(MSCT)and fistula iodinated contrast media revealed the whole fistula and the opening of pyriform sinus of internalfistula. Third branchial cleft fistula was completely excised with functional neck dissection under general anesthesia. Results Of all 6 cases, 3 were misdiagnosed, 2 as neck abscess, and 1 as subacute thyroiditis. There was no recurrence during the follow-up of more than 10 months. Conclusion MSCT and fistula iodinated contrast media can reveal the whole fistula, which is accurate and simple for the diagnosis, and safe for the complete surgical resection of fistula. Functional neck dissection is an effective and safe surgical management for third branchial cleft fistula.

Key words: Functional neck dissection, Branchial fistula, Pyriform sinus, Misdiagnosis

中图分类号: 

  • R739
[1] Goff C J, Allred C, Glade R S. Current management of congenital branchial cleft cysts, sinuses, and fistulae[J]. Curr Opin Otolaryngol Head Neck Surg, 2012, 20(6):533-539.
[2] Prosser J D, Myer C M. Branchial cleft anomalies and thymic cysts[J]. Otolaryngol Clin North Am, 2015, 48(1):1-14.
[3] Süslü N, Süslü A E, Akyol U, et al. Minimally invasive endoscope-assisted surgery for bilateral branchial cleft fistula[J]. Laryngoscope, 2013, 123(9):2296-2299.
[4] Zaifullah S, Yunus M R, See G B. Diagnosis and treatment of branchial cleft anomalies in UKMMC: a 10-year retrospective study[J]. Eur Arch Otorhinolaryngol, 2013, 270(4):1501-1506.
[5] 张小萌, 孔维佳, 杨成章, 等. 功能性颈清扫术在复发性鳃裂畸形治疗中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(6):247-249. ZHANG Xiaomeng, KONG Weijia, YANG Chengzhang, et al. Utilization of functional neck dissection for treatment of recurrent branchial cleft anomalies[J]. J Clin 0torhinolaryngol Head Neck Surg, 2010, 24(6):247-249.
[6] Cai Q, Pan Y, Xu Y, et al. Resection of recurrent branchial cleft deformity using selective neck dissection technique[J]. Int J Pediatr Otorhinolaryngol, 2014, 78(7):1071-1073.
[7] 吴煜农. 颈清扫术式治疗复发性第二鳃裂瘘及囊肿[J]. 口腔医学杂志, 2002, 22(3):163-164. WU Yunong. Neck dissection technique for treatment of recurrent branchial cleft fistula and cysts[J]. J Stomatol, 2002, 22(3):163-164.
[8] 张威, 梁勇, 李湘平, 等. 第三腮裂瘘管的诊治分析: 附病例报告[J]. 中国全科医学, 2012, 15(36):4225-4227. ZHANG Wei, LIANG Yong, LI Xiangping, et al. Diagnosis and Treatment of Third Branchial Fistula[J]. Chin Gen Prac, 2012, 15(36):4225-4227.
[9] 柯赛雄, 李仁济. 选择性颈清扫术在复发性第二三鳃裂瘘管术中的应用[J]. 临床耳鼻咽喉科杂志, 2005, 19(4):183-184. KE Saixiong, LI Renji. Utilization of selective neck dissection technique for treatment of recurrent second or third branchial cleft fistula[J]. J Clin Otorhinolaryngol Head Neck Surg, 2005, 19(4):183-184.
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