Clinical analysis of 12 cases with malformations in the fourth branchial cleft treated by open neck excision assisted by self-retaining laryngoscope
Objective To sum up the clinical experience with the treatment of malformations in the fourth branchial cleft treated by open neck excision assisted by self-retaining laryngoscope.Method Included in this retrospective analysis were 12 patients with malformations in the fourth branchial cleft,treated at our Department from Apr 2014 to Feb 2021.All these patients were treated with open neck excision assisted with self-retaining laryngoscope.Then,summarized were the clinical manifesting features,findings during the operative,operative complications,and prognosis of patients with such a condition.Results The definite diagnosis of these patients was made before the operation and/or confirmed during the operation.Among them,10 patients were determined as fistula in the fourth branchial cleft on left,and 2 were as sinus in the fourth branchial cleft on right.For the 10 cases(83.3%)with a definite diagnosis made before the operation,the internal orificium fistulae were all located within the apex of the pyriform sinus,while 11(91.7%)cases were found with their internal orificium fistulae located within the apex of the pyriform sinus confirmed under the self-retaining laryngoscope.All the lesions in the neck among these cases could be tracked to the vicinity of inferior cornu of the thyroid cartilage and the cricothyroid space.Complete resection of the lesions was achieved among 11 cases at stage one.No vocal cord paralysis occurred following the operation.Only one case was found with the lesion reoccurred one year after the operative because of the internal orificium fistulae not confirmed during the period of surgery,but it was cured by a reoperation with the internal orificium fistulae definitively determined within the apex of the pyriform sinus under the self-retaining laryngoscope,with the lesion no reoccurring during a following up period lasted for 4 years.Conclusion It should be true,based our clinical experience,that the reliable way to diagnose the malformation in the in the fourth branchial cleft might be via a careful examination to the pyriform sinus by a self-retaining laryngoscope under general anesthesia,and such a surgical procedure as open neck excision assisted by self-retaining laryngoscope might be an effective way to cure such a lesion.
the fourth branchial cleft malformationclinical featuresoperation essentialstherapeutic effect
NETL
NSTL
万方数据
