先天性第一鳃裂畸形临床特点分析：附56例报告  

Manifestation of first branchial anomaly:56 cases report

作　　者：张贝[1,2] 陈良嗣[1,2] 黄舒玲[3] 梁璐[3] 吴佩娜[2] 张思毅[2] 罗小宁[2] 卢仲明[2] 

机构地区：[1]南方医科大学,广州510515 [2]广东省医学科学院(广东省人民医院)耳鼻咽喉头颈外科 [3]广州市第一人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第17期1359-1362,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:总结先天性第一鳃裂畸形(CFBCA)的临床特点。方法:回顾性分析2005-05-2015-04期间收治的临床资料完整的56例CFBCA病例。结果:主要临床表现为无痛性肿物(26.8%)、反复肿痛流脓(71.4%)、耳科症状(耳道溢液、听力下降等,28.6%)。37例有感染症状者行脓液或分泌物培养,其中11例阳性,最常见的细菌为铜绿假单胞菌和金黄色葡萄球菌。耳内镜检查可发现耳道狭窄、耳道胆脂瘤样物堆积、耳道底壁骨软骨交接处内瘘口和鼓膜蹼;CT(MRI)典型表现:Pochet's三角区内与耳道关系密切,增强扫描囊壁或管壁可强化的囊状、分叶状或管状异常影,部分病灶与皮肤相通。WorkⅠ型多为囊肿型,常为无感染症状的成年患者(P<0.01);WorkⅡ型多为窦道(瘘管)型,可伴有鼓膜蹼,常为有感染症状的未成年患者(P<0.01)。结论:CFBCA较罕见,多见于未成年患者,左侧好发,常表现为Pochet's三角区内的无痛性肿物、反复肿胀流脓或耳道溢液等。耳内镜、CT和MRI等检查可协助确诊,临床需根据不同表现与相关疾病进行鉴别。Objective.. To sum up and conclude manifestation of congenital first branchial anomaly（CFBCA）. Method.. The clinical data of 56 patients from 2005 to 2015 in our hospital were retrospective reviewed. Result：Manifestation., mass without pain（26.8 % ）, repeated sore and discharge（71.4 % ）, otological symptom（external auditory discharge,hearing loss,28.6%）. Eleven cases bacterial sample showed positive result, and most of them show pseudomonas aeruginosa and staphylococcus aureus. Auricular endoscopy typically performed stricture of external auditory canal, cholesteatoma samples accumulated in ear canal, fistula at the conjunction of the bone and cartilage and tympanic membranous attachment. Typical performance of CT（MRI）was that there were cystic, lobulated or tubular abnormal shadow related with ear canal in Pochetrs triangle area whose cyst wall or pipe wall could been enhanced in enhanced CT（MRI） scans, and part of that could be connected with skin. The statistical difference between type Oslen and Work and clinical characteristics （P〈 0. 01）, and the relationship between type Oslen and Work（P〈0.01）. Most of Work I were cyst type,and these two type often had no infected symptom. Most of them were young patients. Most of Work II were sinus and fistula type ,and these two type often had infected symptom. Most of them were teenagers. Part of patients of type Work II showed tympanic membranous attachment. Conclusion：CFBCA was rare, and it is more common in young patients and often in left part. It always performed as mass without pain,repeated sore and discharge,external auditory discharge. Most of Work I were cyst type,and these two type often had no infected symptom and most of them were young patients o Most of Work II were sinus and fistula type, and these two type often had infected symptom and most of them were teenagers. Auricular endoscopy, CT, MRI could help make diagnose. Doctors clinical need to differentiate it with related diseases according to different manifesta

关 键 词：先天性第一鳃裂畸形 鼓膜蹼 误诊 

分 类 号：R767[医药卫生—耳鼻咽喉科]