새열기형의 임상적 고찰

김장묵,김대식,백승혁,한동렬,김희중,백병준,오천환 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

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.

새성기형

정동원(Dong Won Jeoung),김동의(Dong Yi Kim),윤정한(Jung Han Yoon),제갈영종(Jegal Young Jong) 대한두경부종양학회 1996 대한두경부 종양학회지 Vol.12 No.1

A very important and interesting problem occasionally seen in the neck of children and adults is a branchial cleft anomaly. It is a rare congenital neck disease and presents a painless palpable mass of neck in most cases. We have retrospectively reviewed the medical records of 28 patients operated upon for branchial cleft anomaly at Department of Surgery, Chonnam University Hospital between January, 1991 and December, 1995. Three of these lesions were considered to have originated from the first branchial cleft, and 25 from the second branchial cleft. Females are about twice more common than male patients. Pathological findings showed the cysts were lined squamous epithelium and subepithelial lymphoid follicles in most cases. Five out of 28 patients with branchial cleft anomalies had previous incision procedures. All patients after complete removal of branchial anomalies have no recurrences.

제 1 새성기형의 임상적 고찰

강홍대,문지현,이내호,양경무 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.1

First branchial cleft anomalies are a special group of congenital malformations of the head and neck. The incidence of these lesion is very low, fewer than 10% of all branchial cleft anomalies. This anomaly develops as a result of incomplete fusion of the cleft between the first and second branchial arch.The time when appear clinical symptom has a wide range between the birth and adult, the symptoms occur in the preauricular and cervical region located above a horizontal plane passing through the hyoid bone. The initial symptoms of branchial cleft anomaly was palpable & movable mass, discharge from fistula, no touch pain, and then they are usually associated with infection. Because of difficulty in diagnosis, the inadequate management leads to have recurrence and iatrogenic injury of facial nerve.We have experienced a case of first branchial cleft anomaly that the symptom unusually appear on right cheek in a 27-years-old male patient and so report with the result of surgical extirpation and some reviews of the literatures.

제 1 새열기형

백승대,최득록,표호수,김종곤,전성호,김창원 釜算慶南耳鼻咽喉科學會 1991 임상이비인후과 Vol.2 No.2

비전형적인 형태의 제 1 새성기형 환자 2예

김수종(Su Jong Kim),김태훈(Tae Hun Kim),방승환(Seung Hwan Bang),우정수(Jeong Soo Woo) 대한두경부종양학회 2017 대한두경부 종양학회지 Vol.33 No.1

First branchial cleft anomaly is a very rare disease and exhibits various clinical presentations. Therefore, the diagnosis of first branchial cleft anomaly may be difficult; the condition is often misdiagnosed and mismanaged. Accurate diagnosis is very important, because if not diagnosed correctly, patients with first branchial cleft anomaly would be treated with local incision and drainage repeatedly. We report two cases of first branchial cleft anomaly. The first patient visited for recurrent swell and discharge in the infra-auricular area with a history of previous incision and drainage. The other patient showed a cystic mass in the infra-auricular area and all of them were misdiagnosed initially by their treating specialists elsewhere. The objective of this study is to share our experiences of first branchial cleft anomaly, and emphasize its various clinical patterns and the significance of accurate diagnosis.

선천성 제1새열기형 Type Ⅱ형의 치험례

홍성표,정유석 大韓成形外科學會 2000 Archives of Plastic Surgery Vol.27 No.2

First branchial cleft anomalies constitute less than one percent of all branchial arch anomalies. First branchial cleft anomalies are classified into 2 different types with different embryologic, anatomical and histologic features by Work(1972)Ⅰ. Among 2 types, type Ⅱ anomaly is less common than type Ⅰ and there had been no report of type Ⅱ anomaly in the Korean literatures. We experienced a 5-year-female who had a inflammed cystic mass over neck which was extended into parotid area. After elevation of parotidectomy skin incision and superficial parotid gland, the cystic mass was observed to be extended upward into the parotid gland, medial to the facial nerve and ended at the external auditory canal. microscopic examination shows that cyst wall is lined with squamous epithelium and contains some mesodermal tissue such as pilosebaceous gland and muscle. In conclusion, we can present this case as the first branchial cleft anomaly type Ⅱ.

단일기관에서의 이상와 누공에 대한 경험

석준호,안동빈,손진호,최진혁,정윤영,공지선 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.3

Background and Objectives Pyriform sinus fistula with 3rd and 4th branchial cleft anomaly is an extremely rare congenital condition that is not very well understood owing to its rarity. The aim of the study was to review our experience with pyriform sinus fistulae to better understand them. Subjects and Method Of 163 patients with branchial anomaly treated at our institute between 1999 and 2011, medical records of 15 patients with pyriform sinus fistula were retrospectively reviewed. Results Overall, 9.2% had pyriform sinus fistulae and this proportion was higher than that of patients with 1st branchial anomaly. The mean age at the time of initial symptom presentation was 11.9 years. However, five patients (33.3%) were not diagnosed at that time because pyriform sinus fistula was not suspected. Computed tomography (CT) was the most sensitive diagnostic tool in patients suspected to have pyriform sinus fistulae; the sensitivity of CT was 86.7%, whereas that for esophagography was only 20%. Conservative surgical treatment involving cauterization of the opening of the fistula tract was performed in nine patients and showed favorable results with 22.2% of recurrence rate during a mean follow-up period of 23.1 months. In 67.7% of the patients, the causative organisms were bacteria inhabiting human mouth, suggesting that infection source for pyriform sinus fistula may be food contents and discharge of upper aerodigestive tract. Conclusion The incidence of pyriform sinus fistula may be higher than expected. Therefore, the possibility of pyriform sinus fistulae coexisting should be considered while treating young patients with perithyroidal infection.

편도 개구부가 2개인 제2 새열동 1예

김도훈,이동근 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.5

Second branchial cleft anomaly is the most common type of branchial anomalies. Tonsillitiscan cause inflammation or infection through the cleft tract. We present an extremely rare caseof a 15-year-old female with a tonsil sinus that caused a deep neck infection of the neck, showinga double-sinus opening. The patient was successfully treated with trichloroacetic acid chemocauterization.

제1새열 기형 7예

우훈영 인제대학교 1999 仁濟醫學 Vol.20 No.1

제1새열 기형은 귓바퀴 뒷부분에서 설골을 지나는 수평선 사이에 어느 곳이든 반복되는 감염으로 나타나는 매우 드문 선천성 경부질환으로 희귀성으로 인해 진단이 지연되며 이로 인한 재발, 감염 등이 잦고 확실한 진단없이 수술시 안면신경의 손상을 야기할 수도 있다. 발생기원은 태생기 발육이상에 의한 새성기관 잔유올에 기인하는 것으로 알려져 있으며 낭종(cyst), 동(sinus), 누관(fistula), 연골소(cartilagenous nest), 또는 이들의 복합 형태로 나타난다. 적절한 치료를 위해서는 수술시 인접하여 있는 안면신경이 손상에 유의하고 병변부위를 완전 제거하여야 재발을 방지할 수 있다. 저자는 1989년 4월부터 1998년 1월까지 인제대학 상계백병원 이비인후과에서 Type I 제 1새열기형 5예 및 Type II 제1새열 기형 2예를 치험하였기에 보고하는 바이다. Objective: To identify the clinical and anatomical presentations and to discuss the guide lines for surgical management of anomalies of the first branchial cleft. Patient: Seven patient with first branchial cleft anomalies operated between 1993 and 1998 at our department. Results: Clinically 2 types of presentation; chronic recurrent drainage at postauricular area and persistent fistula in the neck. 5 cases are Work type I and 2 cases are Work type II. Conclusions: Before definitive surgery, all patients underwent multiple incision & drdinage owing to the difficulties in diagnosis. Complete excision without cornplications depends on a good understanding of this anomalies and anatomical features especially facial nerve.

선천성 새성기형

황의호(Eui Ho Hwang),박정수(Cheong Soo Park),최진섭(Jin Sub Choi),권시형(Si Hyung Kwon) 대한두경부종양학회 1994 대한두경부 종양학회지 Vol.10 No.2

One hundred fifty four cases of branchial anomaly treated from January 1987 to July 1993 were analysed to determine clinical features, embryologic and anatomic types of the branchial cleft anomaly, to investigate the differences between adults and pediatrics, and to establish the appropriate treatment plan. The male to female ratio was not signifiacntly different in pediatric and adult patients. The mean symptom duration was 0.5 years(range 0.08-14 years) in pediatric patients and 1.67 years (0.7-7 years) in adult patients. The clinical presentations of these anomalies were lateral neck mass in 112(72.7%), infected discharge in 22(14.3%), non-infected discharge in 6(3.9%), and abscess in 14 cases(9.l%). Sites of the lesions were upper third of the neck in 93(60.3%), infraauricular in 35(22.7%), middle third of the neck in 17(11.0%) and inferior third of the neck in 9 cases(5.8%). The anatomic types were cystic form in 117(75.9%), sinus in 24(15.5%), and fistula in 13 cases(8.4%). Embryologic classification were 124 second branchial cleft anomalies(80.5%), 29 first branchial cleft anomalies(18.8%), and 1 third branchial cleft anomaly(0.6%). Immediate surgery under the uncontrolled infection in 17 cases result in 82.4% recurrent rate(14 cases), and 17.6% cure rate(3 cases). Delayed surgery under the controlled infection in 8 cases recurrent rate(1 case), and 87.5% cure rate(7 cases). In summary, the most common branchial cleft anomaly is second type cyst both in pediatric and adult group, delayed surgical exterpation after infection control with I & D or antibiotics may give a good chance for care and may reduce the recurrence.