先天性第一鳃裂畸形的走行探讨和治疗经验

摘要

目的 对先天性第一鳃裂畸形的走行进行探讨并总结治疗经验.方法 回顾性分析2011年6月至2016年6月收治的10例第一鳃裂畸形患者的临床资料,对第一鳃裂畸形的走行及其手术方式进行分析.结果 2例患者瘘管经腮腺浅面至耳屏处外耳道.5例与面神经总干有密切关系:3例瘘管经总干外侧终于外耳道软骨部,2例瘘管经总干内侧终于外耳道软骨部.2例与颞面干关系密切:1例经颞面干外侧终于外耳道,1例经颞面干内侧终于外耳道.1例与颈面干内侧终于外耳道.本组患者术后随访3~63个月,中位随访时间24个月,8例无复发,1例复发,1例失访.结论 本组病例与腮腺及面神经关系密切,需解剖面神经,处理腮腺浅叶.第一腮裂畸形患者术后均应进行长期随访.%Objective To investigate the first branchial abnormity and summarize the treatment experience. Method The clinical data of 10 patients with first branchial abnormity from June 2011 to June 2016 were analyzed retrospectively. Results 2 cases of fistula were from superficial parotid gland to the ear canal at the tragus. 5 cases were closely related with the total stem of facial nerve:3 cases of fistula were from total stem lateral finally to external auditory canal cartilage, while 2 cases of fistula were from total stem medial finally to external auditory canal cartilage. 2 cases had close relationship with the temporal surface dry, 1 case was outside the temporal surface dry finally to external auditory canal, 1 case was inside the temporal surface dry finally to external auditory canal. The patients in this group were followed up for 3 to 63 months, the median follow-up time was 24 months, 8 cases had no recurrence, 1 case relapsed, and 1 case was lost to follow-up. Conclusions The cases of this group were closely related to the parotid gland and facial nerve. It was necessary to dissect the facial nerve and deal with the superficial lobe of the parotid gland. Long term postoperative follow-up should be performed in patients with the first branchial abnormity.