第三鳃裂囊肿及瘘管2例并文献复习

Two cases of the third branchial cleft cyst and fistulas and literature review

目的探讨第三鳃裂囊肿及瘘管的临床、影像学表现及术前诊断。方法对2例第三鳃裂囊肿及瘘管的临床、影像学表现、术前及病理诊断进行回顾性分析。结果 2例第三鳃裂囊肿及瘘管均位于左侧颈部,反复感染并肿胀,1例为不完全性内瘘管,1例为完全性瘘管,MRI及CT均表现为感染征象,颈部X光片显示为左颈部单个或多个气液平面影,食管稀钡造影表现为钡剂自左侧梨状窝呈细长管状影向前、下方延伸,与颈部气液平面相通。结论颈部MRI或CT对鳃裂囊肿可作出定位诊断,并显示与周围组织间关系,而颈部X光片及食管稀钡造影是诊断第三鳃裂囊肿简便、有效的检查方法,可清晰显示内瘘口、瘘管走行,三者联合对术前诊断及手术方式的选择有重要意义。

Objective To investigate the clinical manifestation, imaging and preoperative diagnosis of branchial cleft cyst and fistulas. Methods The clinical manifestation, imaging, preoperative diagnosis and pathological observation of branchial cleft cyst and fistulas were retrospectively analyzed. Results The branchial cleft cyst and fistulas of the two cases were both located at the left side of neck, infected repeatedly with swelling. One was incomplete fistulas and the other is complete one. MRI and CT scan demonstrated infection signs,and X-ray films showed one or more gas-liquid plane signals on the left neck.The revealed a fine tubular shadow extending forward and downward origing from piriform fossa and conneted with gas-liquid plane. Conclusion The cervical X-ray examination and esophagogram with dilute barium meal is cheap and clear in the diagnosis of branchial cleft cyst and fistulas,while the cervical MRI and CT scan can be used to position fixing. The combination of three imaging examination methods is very important to the preoperatiove dignosis and choice of operation methods