第三腮裂瘘管诊治6例并文献复习  

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

作　　者：李清明 吴思恩 黄素红[1] 曹火太[1] 黄穗华 姚婷婷 刘其洪 

机构地区：[1]深圳市第四人民医院耳鼻咽喉头颈外科,广东深圳518033

出　　处：《山东大学耳鼻喉眼学报》2016年第3期61-64,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：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。Objective To investigate the clinical characteristics,diagnosis and therapy of the third branchial cleft fistula. Methods Clinical data of 6 cases of third barnchial cleft fistula w ere retrospectively review ed,and related literatures w ere review ed. Multi-slice spiral computerized tomography（ MSCT） and fistula iodinated contrast media revealed the w hole fistula and the opening of pyriform sinus of internalfistula. Third branchial cleft fistula w as completely excised w ith functional neck dissection under general anesthesia. Results Of all 6 cases,3 w ere misdiagnosed,2 as neck abscess,and 1 as subacute thyroiditis. There w as no recurrence during the follow-up of more than 10 months. Conclusion MSCT and fistula iodinated contrast media can reveal the w hole fistula,w hich is accurate and simple for the diagnosis,and safe for the complete surgical resection of fistula. Functional neck dissection is an effective and safe surgical management for third branchial cleft fistula.

关 键 词：腮裂瘘管 功能性颈清扫术 梨状窝 误诊 

分 类 号：R739[医药卫生—肿瘤]