摘要
目的：探讨第三鳃裂畸形临床诊断及治疗的方法,总结诊治经验。方法回顾性分析2007年1月1日—2014年7月1日新乡医学院附属平煤神马医疗集团总医院耳鼻咽喉头颈外科手术治疗的21例第三鳃裂畸形患者的临床资料,其中男16例、女5例,年龄11~71岁,平均42.6岁。21例中,初次手术的先天性鳃裂瘘管12例,复发性鳃裂瘘管6例,鳃裂囊肿3例。术前均经彩超、影像学检查,明确畸形病变范围及其解剖关系；术中以美兰或腰麻导管引导,解剖喉返神经并切除瘘管穿行之甲状腺腺叶,完整切除病变组织并修补梨状窝。结果全部患者在拔除鼻饲管后3 d 出院,切口愈合佳。18例患者随访12~84个月（平均36个月）,3例患者随访3~10个月（平均7个月）；21例患者术后无一例复发,无一例因损伤喉返神经、甲状旁腺导致的术后声音嘶哑、低钙血症等。结论第三鳃裂畸形解剖结构复杂,术前必要的检查,术中熟悉咽喉、甲状腺及喉返神经的解剖是处理好该种疾病的关键。
Objective To investigate the clinical diagnosis and treatment of deformity of the third branchial cleft, summarize the experience of diagnosis and treatment. Methods Retrospective analysis the clinical data of 21 patients of the third branchial cleft anomaliesfrom January 2007 to July 2014 in Pingmei Shenma Medical Group General Hospital Affiliated to Xinxiang Medical University for treatment of Otolaryngology Head and Neck Surgery. The patients included 16 males, 5 females, aged 11 - 71 years old, average age was 42. 6 years old. In 21 patients, primary surgery of congenital branchial fistula in 12 patients, recurrent branchial fistula in 6 patients, 3 patients of branchial cleft cyst. Preoperative color Doppler ultrasound, radiology examination, clear abnormalities range and anatomy, intraoperative Meilan or lumbar anesthesia catheter guided, anatomy of recurrent laryngeal nerve and fistula resection through the thyroid gland, complete removal of lesions and repair the piriform fossa. Results All the patients discharged 3 days in the removal of nasal feeding tube, the wound healed well. The 18 patients were followed up for 12 - 84 months, average 36 months, 3 patients were followed up for 3-10 months, average 7 months;no recurrence in all cases after operation, no case due to the injury of recurrent laryngeal nerve and parathyroid leading to postoperative hoarseness, hypocalcemia etc. Conclusions The third branchial cleft is complex in anatomical structure, check the necessary preoperative, intraoperative anatomical larynx, thyroid and laryngeal nerve is the key to deal with this kind of disease.
出处
《中华解剖与临床杂志》
2015年第4期344-346,共3页
Chinese Journal of Anatomy and Clinics
关键词
鳃区
鳃裂瘘管
鳃裂囊肿
诊断
甲状腺切除术
Branchial region
Branchial fistula
Branchial cleft cyst
Diagnosis
Thyroidectomy
