Diagnosis and management of first branchial fistula: a study of 12 cases

来源 :Journal of Otology | 被引量 : 0次 | 上传用户:vazumi126
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Objectives To report authors’ experiences in the diagnosis and treatments of congenital first branchial fistula (congenital auriculocervical fistula). Materials and Methods Twelve cases of congenital first branchial fistula were reviewed. Of these, 8 underwent fistulectomy with facial nerve dissection and partial parotidectomy and 4 underwent simple fistulectomy. Results The inner openings (upper opening) of fistulae lay in the following sites: inferioposterior wall at the junction of cartilaginous and bony segments of the auricular canal and inferior wall of cartilaginous auricular canal. The outer openings(lower opening) lay along the anterior border of upper sternocleidomastoid muscle, at the mastoid tip and posterior to the mandibular angle. Complete fistulae resection was achieved in all but one case. Eleven cases were followed for 5 year with no recurrence. Recurrence occurred in 1 case 6 months after the primary surgery and revision surgery was performed. Conclusions Pre-operative radiography for the location and course of the fistula is crucial for successful fistula resection, especially in cases with past infections. Facial nerve dissection should be done routinely for deeply located fistulae. Objectives To report authors’ experiences in the diagnosis and treatments of congenital first branchial fistula (congenital auriculocervical fistula). Materials and Methods Twelve cases of congenital first branchial fistula were reviewed. Of these, 8 underwent fistulectomy with facial nerve dissection and partial parotidectomy and 4 underwent simple fistulectomy. Results The inner openings (upper opening) of fistulae lay in the following sites: inferioposterior wall at the junction of cartilaginous and bony segments of the auricular canal and inferior wall of cartilaginous auricular canal. The outer openings (lower opening) lay along the anterior border of upper sternocleidomastoid muscle, at the mastoid tip and posterior to the mandibular angle. Complete fistulae resection was achieved in all but one case. Eleven cases were followed for 5 year with no recurrence. the primary surgery and revision surgery was performed. Conclusions Pre-operati ve radiography for the location and course of the fistula is crucial for successful fistula resection, especially in cases with past infections. Facial nerve dissection should be done routinely for heavily located fistulae.
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