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目的:总结颈部囊肿与瘘管的诊治经验。方法:93例行手术治疗,其中鳃裂囊肿15例,鳃裂瘘管10例,皮样囊肿1例,囊状淋巴管瘤4例,甲状舌骨囊肿37例,甲状舌管瘘管25例,癌性淋巴液囊肿1例,随访1~10年。结果:93例中,囊性淋巴管瘤1例复发后失访,另1例行2次手术,癌性淋巴液囊肿1例半年后死于肺转移,鳃裂瘘管2例3次手术,甲状舌管瘘管1例复发,鳃裂瘘管术后1例迟发性面瘫,一次手术治愈,无术后并发症。结论:颈部囊肿与瘘管的诊断除依据术前检查外,主要是依据术中的发现和术后病理检查。B超、CT等是有效的辅助检查手段。治疗上应彻底切除囊壁与瘘管,避免复发。术中应避免损伤颈部的大血管和神经。甲状舌管瘘管须切除舌骨中段2cm,这是防止术后复发的关键。
Objective: To summarize the diagnosis and treatment of neck cysts and fistulas. Methods: Ninety-three patients underwent surgical treatment including 15 cases of branchial cleft cyst, 10 cases of branchial fissure, 1 case of dermoid cyst, 4 cystic lymphangioma, 37 thyroglossal cyst, 25 thyroglossal fistula, One case of lymphatic cyst was followed up for 1 to 10 years. Results: Among the 93 cases, one case of cystic lymphangioma was lost to follow-up after recurrence, and the other 1 case underwent 2 surgeries. One case of cancerous lymphatic cyst died of lung metastasis in half a year and two cases of branchial fistula were operated in 3 cases. One case of tongue tube fistula recurred, one case of delayed facial paralysis after operation of branchial fistula, one operation was cured, no postoperative complications. Conclusion: The diagnosis of neck cyst and fistula is mainly based on the intraoperative findings and postoperative pathological examination except for the preoperative examination. B ultrasound, CT, etc. is an effective means of auxiliary examination. Treatment should be completely removed the wall and fistula to avoid recurrence. Surgery should avoid damage to the neck of large blood vessels and nerves. Thyrogogue fistula to be removed in the middle of the hyoid bone 2cm, which is the key to prevent recurrence.