第 1 鰓裂性瘻孔の 2 例

概要

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Case 1 : A 6 year-old girl had a right mandibular opening with chronic inflammatory induration. She has received four unsuccessful excision elsewhere since 2 years ago. At operation the pathway of the firstula was found to be extended from the jaw angle to the auditory canal. The upper part of the tract penetrated through deep to the facial nerve, which was dissected to avoid it's injury when completing excision of this part. The microscopic exmination revealed multiple components of the first branchial cleft remnant. Cases 2 : A 7 year-old girl had almost the same history and operation findings as the case 1, except a fact that the tract lay superficial to the facial nerve. The operative result of the two cases was excellent without any evidence of recurrence or facial nerve palsy. The first branchial cleft defect is a rare congenital anomaly. From the Japanese literatures we have collected 23 cases with this condition, 17 of which were recognized in the pediatric age. The first branchial cleft and sinus will remain unchanged with repeating inflammatory process until a complete excision of the tract is carried out. The early diagnosis and complete excision of the tract are important in the treatment of this anomaly. The details of the surgical technique how to protect the facial nerve were discussed.
日本小児外科学会の論文