先天性第一鳃裂囊肿及瘘管的诊治探讨

目的 探讨先天性第一鳃裂囊肿及瘘管的诊断和治疗方法。方法 回顾分析1998年2月至2006年9月收治的22例患者的临床资料。结果外瘘口位于耳垂后与乳突之间5例，内瘘口位于外耳道后、下壁骨与软骨交界处3例。两瘘口均有者3例。囊肿位于下颌角3例，耳垂后2例，腮腺筋膜内2例，腮腺峡部外1例，均经手术切除。随访16例，除1例后遗轻度面瘫外，其余病例均彻底治愈。结论 先天性第一鳃裂囊肿厦瘘管临床少见，易误诊、误治。影像学检查是术前确诊的重要依据；充分的术前准备和合理的手术方案是该病治愈的关键，完整切除囊肿度瘘管是避免复发的重要措施。

Study the diagnose and treatment of the congenital first branchial cyst and fistula

Objective To explore the diagnosis and treatment of the congenital first branchial cyst and fistula.Methods The clinical material of 22 patients with branchial cleft cyst and fistula from January, 1998 to September, 2006 were collected and retrospectively analyzed.Results There are 14 cases of branchial cleft sinus.The location of external blind fistula is between earlobe and mastoid process (5 cases).The internal blind fistula is located in the boundary of bone and cartilage in posterior and lower wall of external auditory meatus(respective 3 cases).There are 3 cases that have both external and interal blind fistula .There are totally 8 cases branchial cleft cyst.Among them,3 cases are located in mandibular angle, 2 cases for posterior earlobe,2 cases for fascia of parotid gland , and 1 case for isthmus of parotid gland.All cysts and fistulas were surgical resected.16 cases were followed up.All cases were recovered thoroughly expect one case that had complication of slight facial paralysis.Conclution The cases of the congenital first branchial cleft cyst and fistula are rare in clinic, easily misdiagnosed and treated unfitedly.Definite diagnosis before operation depends on the inspection of image.The key point to cure the diseases is sufficient preparation before operation and the reasonable operation procedure.Complete surgical resection is the important measure to avoid recurrence.