摘要
作者报告了近年收治的１２例儿童梨状窝瘘的诊断与处理经验。患者年龄为１．５～１０岁。１１例表现为左侧颈部炎性肿块，发作期颈部超声检查及核素显像示炎症累及甲状腺左叶，炎症消退后作食管吞钡造影，均证实存在左侧梨状窝瘘；１例为左侧甲状腺无痛性囊性肿块。６例行手术治疗，其中４例予瘘管高位结扎切除；１例术中未能找到瘘管，术后吞钡复查，瘘管消失；１例甲状腺左叶无痛性囊性肿者，术中证实梨状窝瘘伴甲状腺内囊肿形成，行囊肿切除及瘘管高位结扎术。患者术后均恢复良好，随访１～５年无复发。另６例未手术者，５例１～６年无症状，１例２年间有３次发作。作者认为，充分认识梨状窝瘘，对于化脓性甲状腺炎或原因不明的颈部感染的处理具有重要意义。
In 12 patients with piriform sinus fistula,aged from 1 5 to 10 years all but one patient presented themslves with inflammatory swelling in the region of the left lobe of the thyroid gland. During acute infection, the involvement of the left thyroid lobe was verified by ultrasonography and scintigraphy. Barium swallow examination was the diagnostic finding that all the 11 patients had a left sided fistula.One patient presented with a painless cyst in the left thyroid lobe. Six patients operated on 4 underwent fistulectomy. In patient the fistula was not found. In the patient who had a cyst in the thyroid lobe, fistulectomy and cystectomy were done. All these patients did well postoperatively without recurrence.Six other patients were followed up without operation with in 1 6 years. Five patients remained asymptomatic. One patient had 3 recurrences during a 2 years follow up period.Piriform sinus fistula is the most common underlying abnormality in the patients with acute suppurative thyroiditis.A better understanding about this rare branchial anomaly is of clinical importance.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1997年第6期354-356,共3页
Chinese Journal of Surgery
