87例鳃裂畸形临床特征分析

目的 总结鳃裂畸形患者的临床特点，探讨其临床诊疗方案。方法 收集2000年1月—2022年9月确诊为鳃裂畸形的87例患者的临床资料并结合文献进行回顾性分析。结果 本组患者中，第一鳃裂畸形患者10例，第二鳃裂畸形患者52例，第三鳃裂畸形患者20例，第四鳃裂畸形患者5例。15例患者有过相关颈部手术史。所有患者均采取手术治疗，仅1例出现暂时性面神经麻痹，术后3个月恢复。随访6个月至16年，81例患者完成术后随访。6例患者术后出现复发，再次行颈部肿物切除术+等离子梨状窝瘘口封闭术，随访7~8年均未再复发。结论 先天性鳃裂畸形诊断较为困难且相对容易复发,术前结合多种检查可提高诊断准确性，手术彻底切除病灶是首选治疗方案，急性感染期患者先予以颈部清创，待稳定期再行手术切除可以降低术后复发率。

Clinical characteristics of 87 cases of branchial cleft anomalies

Objective To summarize the clinical characteristics of patients with branchial cleft anomalies and to discuss the diagnostic and treatment options.Methods Clinical data of 87 patients diagnosed with branchial cleft anomalies from January 2000 to September 2022 were collected and analyzed retrospectively in the light of the literature.Results In this group, 10 patients had first branchial cleft deformity, 52 had second branchial cleft deformity, 20 had third branchial cleft deformity and 5 had fourth branchial cleft deformity. Fifteen patients had previous history of relevant neck surgery. All patients were treated surgically, and only 1 case had temporary facial nerve paralysis, which recovered 3 months after surgery. Of all the 87 patients, 81 completed postoperative follow-up ranging from 6 months to 16 years. Six patients had recurrence after surgery, and were treated again in our hospital with cervical mass resection plus plasma piriform fossa fistula closure without recurrence during 7-8 years of follow-up.Conclusions The diagnosis of congenital branchial cleft anomaly is difficult and this disease is relatively easy to recur. The preoperative combination of various examinations can improve the diagnostic accuracy, and complete surgical excision of the lesion is the preferred treatment option. In patients with acute infection, cervical debridement should be performed first, and then surgical resection can be carried out in stable period to reduce the recurrence rate.