第三、四鳃裂畸形的临床特征及疗效分析

发布时间：2018-06-04 03:18

本文选题：鳃裂畸形 + 第三鳃裂瘘　；参考：《临床耳鼻咽喉头颈外科杂志》2016年15期

【摘要】：目的:探讨第三、四鳃裂畸形的临床特征、手术方法及手术疗效。方法:对经病理确诊的25例鳃裂瘘管患者行单纯瘘管切除术和选择性颈清扫术。术前均行食管碘水造影及颈部CT、MRI、B超检查。结果:行单纯瘘管切除术的4例患者半年内复发,再次手术时行选择性颈清扫术治疗,随访期内未见复发。23例患者由于反复感染、切开引流或瘘管切除术,导致解剖标志不清,难以找到瘘管,按颈清扫术治疗后治愈。所有患者术后病变组织均送病检,病理回报符合鳃裂瘘管的诊断。术后随访12~36个月,所有经选择性颈清扫术治疗的患者无一例复发,无明显并发症。结论:第三、四鳃裂畸形以复发性急性颈部脓肿或化脓性甲状腺炎或颈下部瘘口分泌物为临床特征,选择性颈清扫术整块切除病变组织是防治复发,有效安全的治疗方法。
[Abstract]:Objective: to investigate the clinical features, surgical methods and surgical efficacy of third and fourth branchial cleft deformities. Methods: 25 patients with branchial fistula were treated with simple fistula excision and selective neck dissection. Before operation, all patients underwent esophagoiodography and cervical CT MRI, B ultrasound examination. Results: four patients who underwent simple fistula resection recurred within half a year and were treated with selective neck dissection during the second operation. During the follow-up period, there were no recurrence. 23 patients had no recurrence, and the anatomic signs were unclear due to repeated infection, incision, drainage or fistula resection. It was difficult to find fistula and was cured by neck dissection. All the postoperative pathological tissues were examined and the pathological results were consistent with the diagnosis of branchial fistula. Follow-up for 12 ~ 36 months showed that none of the patients treated by selective neck dissection recurred and had no obvious complications. Conclusion: third, the four branchial deformity is characterized by recurrent acute cervical abscess or suppurative thyroiditis or lower cervical fistula secretion. Selective neck dissection is an effective and safe method to prevent and treat recurrence.
【作者单位】：昆明医科大学第一附属医院耳鼻咽喉头颈外科;
【基金】：云南省自然基金资助项目(No:2011FZ120)
【分类号】：R762

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