両側に現われた先天性側頸瘻の 1 例

Abstract

Branchial fistulas are commonly believed to be congenital abnormality arising from the remnants of branchial clefts in the embryonic life. A various cases of cervical fistulas have been reported by many in the fields of surgery and otorhinolaryngology. Few reports however have been made in the field of oral surgery. Furthermore, reports on cases of bilateral cervical fistulas are very rare in the literature of this country. We have recently experienced a case of congenital fistula occurring symmetrically in the bilateral neck of a girl aged 9. In this case, the fistulas of the bilateral neck were evident at birth. The complaints were swelling of the neck and intermittent drainage from a small orifice in the neck. The cutaneus orifice is located in the inferior carotid triangle and on a line along the anterior border of the sternomastoid muscle. The tracts are imcomplete (with an end each closed) and run from the external opening through the subcutaneus tissue, the platysma muscle, and to the superficial layer of the deep fascia. They then take a course upward along the internal jugular vein until they reach the deep structures around each hyoid bone. Pathohistological examinations revealed that columnar and stratified squamous epithelium lined the tract wall and that tract was composed of lymphoid tissue, salivary gland and muscle. Judging from the foregoings, the fistulas are considered to have originated from the second inner branchial groove in the embryonic life.