새열기형의 임상적 고찰 = A Clinical Study of Branchial Cleft Anomalies

다국어 초록 (Multilingual Abstract)

Background and Objectives : Branchial cleft anomalies are encountered rarely in clinical practice. We reviewed medical records of branchial cleft anomalies according to age and sex distribution, site distribution, characteristics of mass on physical examination, location of mass, preoperative diagnosis, type of branchial cleft cyst and report our experience with 25 cases of branchial cleft anomalies. Materials and Methods : A review of medical records was performed on 25 cases of branchial cleft anomalies diagnosed in pathologic report from January, 1990 to March, 2000. Result : Sex distribution was 11 male and 14 female, age distribution was most common in third decade which was 8 cases(32%). Site distribution was predominant in left side(13 cases), and in physical examination, the characteristics of the mass was nontender(76%), mobile(60%), soft(80%). The lesion site was submandibular area in 2 cases, upper 1/3 portion of sternocleidomastoid muscle(SCM) in 2 cases, middle 1/3 portion of SCM in 20 cases and parotid area in 1 case. The preoperative diagnosis was branchial cleft cyst in 16 cases, cervical lymphadenitis in 3 cases, tuberculous lymphadenitis in 3 cases, branchial cleft fistula in 1 case, dermoid cyst in 1 case and parotid mass in 1 case. Among 25 cases, first branchial cleft cyst was seen in 4 cases, second branchial cleft cyst in 20 cases and second branchial cleft fistula in 1 case. Conclusion : The clinical history of recurrent neck inflammatory episodes in young patients and nontender, mobile, soft neck mass should raise the suspicion of this entity. Investigation using CT scanning in combination with aspiration is useful. Treatment of all branchial cleft anomalies is complete surgical excision because there is lack of spontaneous regression, a high rate of recurrent infection, the possibility of other diagnosis, and rare malignant degeneration. Complete removal without complications depends on a good understanding of regional embryogenesis, a knowledge of the surrounding structure, and awareness of the different anatomical presentation.