Second branchial cleft fistula: Is fistulogram necessary for complete excision

Rattan, Kamal Nain; Rattan, S.K; Parihar, Dheeraj; Gulia, Joginder Singh; Yadav, S. P. S.

doi:10.1016/j.ijporl.2005.10.014

Cited by 37 publications

(38 citation statements)

References 11 publications

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“…However, as a result of material extension beyond the fistula, an error may occur in the exact location of the tract. [12] Similar errors are possible using liquid paraffin and quick-hardening polymer. [12] Second method is intraoperative fistulography.…”

Section: Discussionmentioning

confidence: 91%

“…[12] Similar errors are possible using liquid paraffin and quick-hardening polymer. [12] Second method is intraoperative fistulography. [12] However, it was observed in the studies conducted that this method is not so useful for the surgeon.…”

Section: Discussionmentioning

confidence: 91%

“…Total excision of the fistula between ages 2-3 before recurrent infection and formation of fibrosis in surrounding tissue is generally the main treatment recommendation. [12] Surgical excision of the fistula tract constitutes challenges because of the lengthiness of the tract and its relation to anatomically important neurovascular structures.…”

Section: Discussionmentioning

confidence: 99%

“…[12] The first method is a stepladder process aiming to provide extensive surgical exposure by two or more horizontal incisions. [12] Using this method, methylene blue, liquid paraffin, or quick-hardening polymer may be used to determine the tract. Marking the tract with methylene blue is recommended in order to demonstrate it intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…[12] Second method is intraoperative fistulography. [12] However, it was observed in the studies conducted that this method is not so useful for the surgeon. [12,13] It also introduces an additional radiation burden on the patient.…”

Section: Discussionmentioning

confidence: 99%

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Guide-assisted excision of the second branchial cleft fistula: a technical strategy

Aydın¹

2017

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ÖZDoğuştan boyun kitleleri sıklıkla karşılaşılan boyun kitleleridir; brankial anomaliler bunların en sık nedenlerindendir. En sık görülen brankial anomalisi tip 2 lezyonlardır ve çoğunluğu kistlerden oluşmaktadır. Brankiyal yarık kisti nadiren gözlemlenir ve tedavide tekrarlayan deşarjlar ile görülür. Başlıca tedavi yöntemi, fistül yolunun kesin olarak cerrahi eksizyonudur. Bu amaçla tanımlanan birçok yöntem vardır ancak altın standart yöntem henüz bulunmamıştır. Özellikle cerrahide zorluklar vardır, bu nedenle fistül yolu önemli nörovasküler dokulara geçmektedir. Dolayısıyla, ameliyat sırasında lakrimal probu kullanılarak fistül yolu belirlendi ve cerrahi olarak çıkarıldı. Hastanın fistülü komplikasyon olmadan ve güvenli bir şekilde bu yöntem ile alındı.Anahtar sözcükler: Doğuştan boyun kitleleri; rehber destekli yöntem; ikinci brankiyal kist; cerrahi eksizyon. ABSTR ACTCongenital neck masses are frequently observed neck masses; branchial anomalies constitute one of the most common reason. The most common branchial anomaly is type 2 lesions and majority of them are constituted by cysts. Branchial cleft fistula is rarely observed and appears with recurrent discharges in the clinic. The main treatment method is the exact surgical excision of the fistula tract. There are many methods defined for this purpose but the gold standard method is not found yet. Particularly, there are difficulties in the surgery, therefore fistula tract passes to important neurovascular tissues. Thus, we made apparent the fistula tract by using the lacrimal probe during the operation and excised it surgically. The patient's fistula was excised in an uncomplicated and safe way with this method.Keywords: Congenital neck masses; guide-assisted method; second branchial fistula; surgical excision. Many congenital masses are present in the head and neck area and 20-30% are formed by branchial anomalies. [1,2] Cysts constitute 75% of branchial anomalies, while 25% are constituted by fistulas. Branchial cysts were first defined by Ascherson in 1832, and many theories have been implicated in their formation. The branchial apparatus theory, cervical sinus theory, pharyngeal theory and inclusion theory have been proposed, but the most widely accepted theory is that of incomplete branchial cleft and pouch closure in embryogenesis. [2,4,5] Most observed branchial clefts (95%) are type 2, followed by type 1 (1-5%) as the second most common.[6] We present a surgical excision technique using lacrimal probe guides in a patient with type 2 branchial fistula. CASE REPORTA 24-year-old female patient was admitted to the otorhinolaryngology clinic with a complaint of swelling and discharge on the right side of the neck since childhood. The discharge appeared from time to time and did not respond to treatment. On physical examination, a soft mass over the medial sternocleidomastoid muscle border with an anteroinferior fistula opening 4 cm superior to the clavicle were observed on the right side

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Section: Discussionmentioning

confidence: 91%