Branchial Cleft Cyst (Fistula) Clinical Diagnosing And Treating Research

Objective: To investigate the clinical manifestation of branchial cleft cyst (fistula) and provide some clinical experience on its diagnosis and treatment to avoid misdiagnosis and mistherapy.Methods: Retrospective analysis of September 1996 to December 2009 29 cases of surgical treatment of branchial cleft cyst and fistula of the clinical data, including preoperative medical history, examination, diagnosis, treatment and pathological diagnosis and follow-up results, Summary branchial cleft cyst (fistula) in clinical manifestations,anatomical relations and various treatment methods in the value of its diagnosis and treatment.Results: All cases were pathologically confirmed as branchial cleft cyst (fistula), there were 11 patients(37.9%)with first branchial cleft cyst or fistula , 17 patients(58.6%)with second branchial cleft cyst or fistula ,1 patients(3.4%)with the third branchial cleft or fistula .1 patient was found with external fistula and cyst,2 patients with internal fistul and cyst, 2 patients with incomplete internal fistula , 2 patients with internal and external fistula, 4 patients with incomplete external fistula , 18 patients with solitary cyst, and no malignant and associated with TB cases. The first branchial cleft cyst (fistula) with the facial nerve and the external ear relations are close, and the variation is big, the second and third branchial cleft cyst (fistula) with the carotid artery sheath, the hypoglossal glossopharyngeal and vagus nerves and so on relations are close. Misdiagnosis rate of 31.0% (9 / 29), the recurrence rate was 41.3% (12/29). Preoperative examination of the various auxiliary: B ultrasound diagnosis of cystic meet the rate of 72.2% (13/18), 40% lipiodol angiography and X-ray diagnosis of fistula in line with the rate of 63.6% (7 / 11). 0.5-12 years follow-up, 2 cases of patients had recurrence, after the second complete resection lesions, there are no one recurrence from then to today.Conclusions: In the ongenital branchial cleft cyst (fistula), the first and second branchial cleft cyst (fistula) is the most common clinical forms, variety of clinical forms,anatomical complexity, easier to misdiagnosis, wrong treatment induced relapse. Preoperative ultrasonograpy is the first choice fordiagnosis of branchial cleft cyst . But the 40%iodine oilradiography and X picture have the high diagnosis rate to fistula. Complete resection including the cyst and fistula is the only effective cure for the branchial cleft cysts (fistula).