摘要
目的 探讨儿童先天性第二鳃裂畸形(congenital second branchial cleft anomalies,CSBCAs)的临床诊治方法,为规范CSBCAs的诊疗提供参考。方法 回顾性分析上海交通大学医学院附属儿童医院耳鼻咽喉头颈外科2016年6月~2021年6月经手术治疗的38例CSBCAs患儿的临床资料。纳入研究的项目包括年龄、性别、部位、起病年龄、主要症状和体征、感染史、手术史、病程、畸形类型、影像学检查、手术年龄、Bailey分型、并发症和复发情况等。结果 囊肿型9例,瘘管型29例。24例患者术前有感染史,14例无感染史。16例曾行颈部脓肿切开引流术,1例曾行次颈部肿物切除术。主要症状包括颈侧皮瘘29例,颈侧炎性肿物6例和颈侧无痛性肿物3例。病程1个月~14.4年,中位数25.5个月。1例行瘘管切除术及同侧扁桃体切除术。BaileyⅠ型9例,Ⅱ型24例,Ⅲ型2例,Ⅳ型3例。随访25个月,无并发症,无复发。结论 儿童颈侧三角区肿物或皮瘘,颈部增强CT显示胸锁乳突肌前缘内侧、颌下腺后方、颈动脉鞘外侧单房类圆形囊状低密度影,囊内未见分隔、气体,未累及舌骨、甲状腺、腮腺、外耳道或者面神经时,应考虑CSBCAs可能。高位结扎足以避免复发,不推荐同时行患侧扁桃体切除术。
OBJECTIVE To explore the clinical diagnosis and treatment of congenital second branchial cleft anomalies(CSBCAs) in children,so as to provide reference for the standard diagnosis and treatment of CSBCAs.METHODS We conducted a retrospective study on 38 children who were referred to Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University from June 2016 to June 2021 for the treatment of CSBCAs.The age,gender,location of the lesion,age at presentation,clinical manifestations,infection history,operation history,course of disease,type of malformation,imaging data,operation age,Bailey classification,complications and recurrence were recorded.RESULTS There were 9 cases with cyst and 29 cases with fistula.Twenty-four patients had a history of infection before operation,and 14 patients had no history of infection.Sixteen cases had undergone incision and drainage of neck abscess,and one case had undergone subtotal neck tumor resection.The main symptoms included cervical cutaneous fistula in 29 cases,cervical inflammatory mass in 6 cases and cervical painless mass in3 cases.The course of disease ranged from 1 month to 14.4 years,with a median of 25.5 months.Fistula resection and ipsilateral tonsillectomy were performed in one case.There were 9 cases of Bailey type I,24 cases of type II,2 cases of type III and 3 cases of type IV.After 25 months follow-up,there were no complications and recurrence.CONCLUSION In children with mass or skin fistula in the cervical triangle,enhanced CT in the neck showed a round cystic low-density shadow in the anterior edge of the sternocleidomastoid muscle,behind the submandibular gland and lateral to the carotid sheath with no involvement of the hyoid,thyroid,parotid gland,external auditory canal or facial nerve,and there was no septum or gas in the capsule,CSBCAs should be considered.High ligation of the fistula can avoid recurrence,and simultaneous tonsillectomy is not recommended.
作者
陈伟
徐蓉
徐梦柔
周宜龙
陈佳瑞
陈淑梅
王颖
徐宏鸣
李晓艳
CHEN Wei;XU Rong;XU Mengrou;ZHOU Yilong;CHEN Jiarui;CHEN Shumei;WANG Ying;XU Hongming;LI Xiaoyan(Department of Otolaryngology Head and Neck Surgery,School of Medicine,Shanghai Jiao Tong University,Shanghai,200062,China;Dpartment of Radiology,Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai,200062,China;Department of Children Otolaryngology Head and Neck Surgery,Shenzhen Hospital of Southern Medical University,Shenzhen,Guangdong,518000,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2022年第4期263-267,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
儿童
外科手术
先天性第二鳃裂畸形
Bailey分型
胸锁乳突肌
颌下腺
颈动脉鞘
Child
Surgical Procedures
Operative
congenital second branchial cleft anomalies
Bailey classification
sternocleidomastoid muscle
submandibular gland
carotid sheath
