第三腮裂瘘管诊治6例并文献复习

目的 探讨第三腮裂瘘管的临床特征及治疗方法。 方法 回顾性分析6例第三腮裂瘘管患者的临床资料,包括术前检查、手术治疗过程及疗效,并复习相关文献。行多层螺旋CT及瘘管碘造影剂造影,能显示瘘管走行及内瘘口位于梨状窝,全麻下应用功能性颈清扫术式彻底切除瘘管,术后切口一期愈合。 结果 6例中误诊3例,包括颈部脓肿2例、亚急性甲状腺炎1例。随访10个月以上无复发。 结论 多层螺旋CT及瘘管碘造影剂造影可显示瘘管全程,诊断准确、简便,为彻底切除病变提供安全保障。功能性颈清扫术能切除瘘管全程,是一种安全、有效的治疗手段。

Diagnosis and treatment of the third branchial cleft fistula:a clinical report of 6 cases and literature review

Objective To investigate the clinical characteristics,diagnosis and therapy of the third branchial cleft fistu-la.Methods Clinical data of 6 cases of third barnchial cleft fistula were retrospectively reviewed,and related litera-tures were reviewed.Multi-slice spiral computerized tomography (MSCT)and fistula iodinated contrast media revealed the whole fistula and the opening of pyriform sinus of internalfistula.Third branchial cleft fistula was completely excised with functional neck dissection under general anesthesia.Results Of all 6 cases,3 were misdiagnosed,2 as neck ab-scess,and 1 as subacute thyroiditis.There was no recurrence during the follow-up of more than 10 months.Conclusion MSCT and fistula iodinated contrast media can reveal the whole fistula,which is accurate and simple for the diagno-sis,and safe for the complete surgical resection of fistula.Functional neck dissection is an effective and safe surgical management for third branchial cleft fistula.