先天性第一鳃裂瘘14例报告

Congenital first branchial cleft fistula:a report of 14 cases

目的总结14例先天性第一鳃裂瘘的诊治经验,提高手术切除第一鳃裂瘘的安全性和治愈率。方法对1986年9月～2005年10月本科收治的14例第一鳃裂瘘的临床资料进行回顾性分析,选择适当的瘘管示踪方式探查其走行,作Y形切口,切除或外翻腮腺浅叶,先找出面神经主干,再分离瘘管,处理内口时切除部分外耳道软骨。结果14例均一次手术治愈,随防1～19年,失访2例,其余无复发。结论术前明确诊断,充分暴露面神经干,完整切除瘘管是手术成功的关键。

Objective To present the diagnostic and therapeutic strategies for congenital first branchial cleft fistula in 14 cases. Methods The clinical data of 14 cases, admitted to our department between September 1986 and October 2005, were retrospectively analyzed. The entire course of the fistula was identified correctly. The facial nerve was found at the foramen stylomastoideum at fist, then the fistula could be separated successfully from them. A piece of cartilage of external auditory meatus was resected concomitantly with the fistula opening. Results The wounds of 14 cases healed by first intention. There was no recurrence with the follow-up period of one year to 19 years except 2 cases who lost to follow-up. Conclusion The key point to cure branchial cleft fistula lies in a definite diagnosis before operation, a complete resection and a full exposure of the facial nerve.