[Results of the surgical treatment of children with residual developmental anomalies of the 1st and 2d branchial clefts and thyroglossal duct].
The purpose of this study was assessment of the results of surgical treatment of children with developmental anomalies derived from the first and second branchial clefts and thyroglossal duct. Normal and abnormal development of branchial arches and clefts, pharyngeal pouches and thyroglossal duct, as well as the anatomy nd topography of the resulting developmental anomalies are discussed. The observed developmental anomalies are classified into: cysts, cysts with sinuses developing as a result of inflammatory processes, puncture, incision, operation, dermal sinuses draining externally, dermal sinuses with external and internal orifices, the latter in the groove of the palatine tonsil or foramen caecum of the tongue, dermal sinus with external orifice and dermal fistula. Methods of diagnostic investigations and surgical treatment are described. The cysts derived from the first and second branchial arches were treated surgically by a transverse incision running across the peak of the bulging cyst. Removal of the cyst was started by dissection of the anterior and lateral surfaces of the wall, and then the posterior wall was dissected free from the deep structures in the neck. In cases of cysts with fistulae or dermal sinuses the operation was preceded by injection of 1% methylene blue into its external orifice. In this way it was possible to stain the walls of the cyst or sinus and to mark its end. The operation was started with elliptical excision of the external orifice of the lesion. In cases of dermal sinuses derived from the first branchial clefts an additional incision was made along the posteroinferior border of attachment of the auricule to the skull. In operations of dermal sinuses derived from the second branchial cleft after dissection of the wall at a distance of several centimeters a second incision was made transversely for easier dissection of the sinus wall lying in deeper parts of the neck. Removal of the cysts and sinuses derived from the thyroglossal duct required always resection of the middle part of the body of the hyoid bone. Upward elevation of the cut hyoid bone body visualized the upper part of the thyroglossal duct up to its end in the lingual foramen caecum, and made possible removal of this part. The cut hyoid bone body was left divided. In the years 1953-1976 56 children were treated surgically for these developmental anomalies. The material comprised 33 girls and 23 boys. Three groups of patients were isolated. Most children were operated upon between the 5th and the 9th year of life at the age of 12 years.(ABSTRACT TRUNCATED AT 400 WORDS)
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000151:congenital* / Q000209:etiology / Q000601:surgery; D005260:Female; D005402:Fistula / Q000151:congenital* / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009333:Neck / Q000002:abnormalities*; D011183:Postoperative Complications / Q000453:epidemiology
Ocena wyników leczenia operacyjnego dzieci z pozostałościami rozwojowymi I i II szczeliny skrzelowej oraz przewodu jezykowo-tarczowego.