双侧先天性第一鳃裂瘘一例报告

Bilateral Congenital First Branchial Cleft Fistulas: A Case Report

目的总结双侧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。方法回顾性分析双侧先天性第一鳃裂瘘1例的临床诊治资料。结果本例间隔半年均以耳部疼痛流脓并耳垂后肿痛就诊,专科检查结合耳后B超确诊为第一鳃裂瘘,予切除术。本例双侧先天性第一鳃裂瘘均一次手术治愈。右侧随访18个月、左侧随访12个月,双侧均无复发。结论第一鳃裂瘘临床比较少见,症状、体征不典型,病理检查是确诊的重要依据,手术彻底切除病变组织是治愈本病的唯一方法。

Objective To summarize the experience of diagnosis and treatment of the bilateral congenital first branchial cleft fistula in order to improve the safety and cure rates of surgical ablation of the first branchial cleft fistula. Methods Retrospective analysis of clinical data of 1 patient with the bilateral congenital first branchial cleft fistula was made. Results The patient had paid two visits for suppuration in aural region and sore pain at the posterior surface of auricular lobule in 6 months. The patient was confirmed as having first branchial cleft fistula by specialized detection combined with type-B ultrasonic of post aurem and underwent exsection. The patient with the bilateral congenital first branchial cleft fistula was cured following just one surgery. There was no recurrence at bilateral branchial fistula and the right-side was followed up for 18 months and the left-side for 12 months. Conclusion The first branchial cleft fistula is rare in clinical practice, and the symptoms and signs are atypical. Pathological detection is very important for the final diagnosis. Thorough excision of tissue of morbid change is the only method to cure the disease.