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患者男,24岁.5年前发现右颈前有一瘘口,经常渗出粘性液体,未做治疗.半月前因感吞咽不适而来本院就诊.检查:右颈下部胸锁乳突肌前缘可触及一条索状物,挤压时瘘口有分泌物溢出.耳鼻喉科检查未见异常.1 X线检查 经外瘘口注入76%泛影葡胺3ml,照颈部正侧位片,见瘘管位于颈椎前方左侧,自胸锁关节平面向上延伸至口咽部,全长约18cm,最宽处约0.6cm.部分造影剂经咽部进入食道.X线诊断:右侧鳃裂瘘管.2 手术所见 经瘘管外口注入美兰溶液,内口从扁桃体后弓流出.颈部做阶梯形切口三处,沿瘘管剥离,逆口牵出,再从扁桃体后弓切开分离,瘘管完整切除,全长17cm,中部有一分支,长约1.5cm.
Patient male, 24 years old. Found 5 years ago, there is a fistula in front of the right neck, often exudate viscous liquid, not treated. Half a month before swallowing discomfort came to our hospital. Check: lower right sternocleidomastoid Edge can touch a cord-like, squeezed fistula discharge secretions. Otolaryngology examination no abnormalities .1 X-ray examination through the external fistula injection of 76% diatrizoate meglumine 3ml, according to the neck is a lateral film See the fistula in the left front of the cervical spine, since the thoracic joint plane extends upward to the oropharyngeal, the total length of about 18cm, the maximum width of about 0.6cm .A part of the contrast agent into the esophagus through the pharynx.X line diagnosis: the right branchial cleft Fistula .2 surgical see through the fistula outside the mouth into the Meilan solution, the mouth from the tonsil bow out of the neck to do step-shaped incision three, along the fistula peel, reverse port pull, and then cut off from the tonsils after the arch, Fistula complete resection, full-length 17cm, a branch in the middle, about 1.5cm.