甲状舌管囊肿及瘘管复发的原因探讨和处理

The Reason and Disposal of Thyroglossal Duct Cyst and Fistula Recurrence

目的探讨甲状舌管囊肿(瘘管)术后复发的原因和预防措施。方法回顾分析28例甲状舌管囊肿(瘘管)病例(含7例术后复发者),术前感染病例先行抗炎治疗,通过查体及B超检查,准确判定甲状舌管囊肿(瘘管)与舌骨关系,处理舌骨;术前一天或术中先注亚甲蓝液入囊管内示踪,行S istruk术式,仔细分离分支,手指触诊疑为残存病灶处,行环形缝扎或射频、微波等处理。结果28例均获成功,随访一年以上未见复发。结论对甲状舌管囊肿(瘘管)的病人,在手术时要认真仔细,尤其在处理小分支要彻底,切除中段舌骨应稍宽,是可以有效的防止复发。

Objective To discuss the reason of recurrence of thyroglossal duct cyst and fistula after operation and how to prevent it. Methods To analyze 28 cases with thyroglossal duct cyst and fistula （ 7 cases of recurrence after operation）. The infected cases were treated with antibiotic first before operation, and judged the relationship between thyroglossal duct cyst （fistula） and hyoid bone exactly through checking and sonography , and then to deal with hyoid bone. First,we should inject methylthioninium chloride in the auditory tube to trace one day before the operation or during the operation, with Sistruk operation, and separate the little branches during operation, handling the focus of infection with radio frequency and microwave or armillary transfixion and so on. ResuRs 28 cases didn＇t recur during the first one year after operation. Conclusion We should be careful during the operation , especially handle the little branches and cut the middle of the hyoid bone a little broadly, this may be to prevent recur effectively.