第一鰓裂由来の側頚瘻の1例

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Anomaly of the first branchial cleft is relatively rare when compared with those of the second. Aronsohn showed that the incidence of this anomaly was less than 1% of all the branchial anomalies.A case of the first branchial anomaly occurring in a girl aged 5 years is presented. She was admitted to Mie University Hospital on November 1, 1979, because of painful swelling beneath and posterior to the left ear lobe, and an abscess adjacent to the hyoid bone which had been incised and drained. A contrast X-ray study was carried out and revealed a tract of 7cm in length extending down from the postauricular region to the left part of the hyoid bone. The diagnosis of the fistula of the first branchial cleft was made. On November 13, 1979, the fistula was dissected under general anesthesia. The fistula lay deep to the main trunk of the facial nerve, extended down along with the stylohyoid muscle and ended in the left part of the hyoid bone. The upper part of the fistula ended blindly at the cartilage of the external auditory canal. The excised fistula was 7cm in length and 0.5cm in diameter. Histopathological examination revealed a sinus tract lined by stratified squamous epithelia containing hair bulbs and sweat glands.Seventy one cases of the first branchial cleft anomaly collected from the international literature were analyzed in terms of histopathological findings and the relationship of the fistula to the facial nerve based on the classification proposed by Belenky and Medina. The case of a first branchial anomaly reported here is believed to be the 14th such case ever reported in the Japanese literature.
耳鼻咽喉科臨床学会の論文

第一鰓裂由来の側頚瘻の1例

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