摘要
目的:探讨WorkⅠ型先天性第一鳃裂畸形(CFBCA)的区域毗邻解剖关系及分型。方法:回顾性分析资料完整的48例WorkⅠ型CFBCA资料。结果:48侧病损均完整切除;48侧(100%)均解剖保留面神经;33侧(68.8%)行腮腺部分切除、9侧(18.8%)行腮腺浅叶+深叶部分切除、6侧(12.5%)未行腮腺切除;32侧(66.7%)行外耳道重建;43侧(89.6%)行耳大神经耳垂支解剖保留;9侧(18.8%)同期行择区颈清。45侧WorkⅠ型CFBCA呈不规则囊状或分叶结构,病损主体位于外耳道骨与软骨交汇处后下方,沿外耳道纵轴分布;3侧孤立于腮腺浅叶实质内。所有病损均位于面神经主干及分支浅面,病损下缘与面神经主干出茎乳孔处的最短垂直距离平均值7.2(0~13.4)mm。基于术前影像及术中所见,根据病损与外耳道、腮腺和面神经的毗邻关系,提出WorkⅠ型先天性第一鳃裂畸形的分型,具体分为4型:C1型(外耳道后壁型)17例(35.4%)、C2型(外耳道底壁型)13例(27.1%)、C3型(外耳道多壁型)15例(31.3%)、C4型(孤立于腮腺实质型)3例(6.3%)。结论:WorkⅠ型CFBCA与区域毗邻解剖关系密切,熟悉WorkⅠ型先天性第一鳃裂畸形的分型,有助于因型施治、精准切除。
Objective:To explore the adjacent anatomic relationship and classification of WorkⅠcongenital first branchial cleft anomaly(CFBCA)in order to guide clinical practice.Method:The data of 48 cases of WorkⅠCFBCA with complete data were analyzed retrospectively.Result:All 48 lesions were completely resected.48 sides(100.0%)were anatomically preserved facial nerve,partial parotidectomy was performed on 33 sides(68.8%),superficial lobe+deep lobe partial parotidectomy was performed on 9 sides(18.8%),and 6 sides(12.5%)was not performed parotidectomy.External auditory canal reconstruction was performed on 32 sides(66.7%);43 sides(89.6%)underwent the anatomical preservation of the auricular lobe branch of the great auricular nerve;9 sides(18.8%)was performed selective cervical lymphadenectomy at the same time.45 sides of WorkⅠCFBCA presented irregular cystic or lobulated structure,the lesion was located below and behind the junction of the external auditory meatus bone and cartilage and distributed along the longitudinal axis of the external auditory canal;3 sides were isolated in superficial lobe parenchyma of parotid gland.All lesions were located on the superficial surface of the main trunk and branches of the facial nerve.The average value of the shortest vertical distance between the lower edge of the lesion and the outlet of the main trunk of the facial nerve at the stylomastoid foramen was 7.2(0-13.4)mm.Based on preoperative images and intraoperative findings,according to the adjacent relation with external auditory meatus,parotid gland and facial nerve,the classification of WorkⅠcongenital first branchial cleft anomaly is proposed,which is specifically divided into 4 types:C1(posterior wall of the external auditory meatus)17 cases(35.4%),C2(inferior wall of the external auditory meatus)13 cases(27.1%),C3(multi wall of the external auditory meatus)15 cases(31.3%),C4(isolated from parotid gland parenchyma)3 cases(6.3%).Conclusion:WorkⅠCFBCA has a close relationship with the adjacent anatomy of the region,and
作者
陈良嗣
张贝
许咪咪
周正根
黄艳
徐贤贞
梁璐
宫喜翔
黄舒玲
CHEN Liangsi;ZHANG Bei;XU Mimi;ZHOU Zhenggen;HUANG Yan;XU Xianzhen;LIANG Lu;GONG Xixiang;HUANG Shuling(Department of Otolaryngology Head and Neck Surgery,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangzhou,510080,China;Department of Otolaryngology Head and Neck Surgery,the University of Hong Kong-Shenzhen Hospital;Department of Radiology,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2020年第8期695-700,共6页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
WorkⅠ型
先天性第一鳃裂畸形
面神经
外耳道
淋巴结清扫术
Work typeⅠ
congenital first branchial cleft anomaly
facial nerve
external auditory meatus
selective cervical lymphadenectomy
