74例鳃裂囊肿及瘘管临床分析

Clinical analysis of 74 cases of branchial cleft cysts and fistulas

目的总结74例鳃裂囊肿及瘘管的临床特点,探讨其诊疗方法。方法收集2010年1月至2019年9月收治的74例鳃裂囊肿和鳃裂瘘患者的临床资料并结合文献进行回顾性分析。结果本组患者中有50例为第二鳃裂病变,13例为第一鳃裂病变,10例为第三鳃裂病变,1例为第四鳃裂病变,于我院初次手术时术前误诊率为10.81%。所有患者均采取手术治疗,随访3个月~10年。除3例失访患者外,67例患者一次性治愈,3例患者术后复发,1例患者术后出现永久性面神经麻痹。结论先天性鳃裂囊肿及瘘管临床表现多样,鉴别诊断较为复杂,应合理选用多种检查手段,术前准确评估,制定个体化的手术方案彻底切除病灶是首选治疗方法。

Objective This study aimed to describe the clinical features of 74 patients with cleft palate cysts and fistulas and analyze the diagnosis and treatment methods.Methods Between January 2010 and September 2019,the clinical data of 74 patients with branchial cleft cysts and fistulas were retrospectively reviewed and analyzed with related literature in our department.Results Of the 74 patients,50 patients were diagnosed with second branchial cleft anomalies,13 patients had first branchial cleft lesions,10 patients had third branchial cleft lesions,and one patient had a fourth branchial cleft lesion.All patients received surgical treatment.After the exclusion of 3 patients who were lost to follow-up,67 patients were successfully treated,3 patients reported relapse,and 1 had permanent facial paralysis.Conclusions The clinical manifestations of congenital cleft palate cysts and fistulas are diverse,and the differential diagnosis is complicated.It is essential to perform a detailed physical examination and preoperative evaluation to make an accurate diagnosis.The approach for management is individualized,and surgical rehabilitation is the preferred treatment.