Diagnostic value of multi-slice spiral computerized tomographic fistulography in congenital fistula of neck

Abstract

Objective: To investigate the usefulness and effectiveness of multi-slice spiral computerized tomographic fistulography (MSCTF) in the diagnosis and treatment of congenital fistula of neck. Methods: Thirty-four patients with thyroglossal fistulasor branchial cleft fistulas who were initial treated from July 2008 to August 2015 in Fujian Provincial Hospital were retrospectively analyses. Thirteen males and 21 females patients aging from 3 to 46 years old with a median age of 37 were included. There were thyroglossal fistula in 6 cases, the first branchialcleft fistula in 9 cases, the second branchialcleft fistula in 3 cases, the third branchialcleft fistula in 9 cases, and the fourth branchialcleft fistula in 7 cases. All the patients underwent preopeative MSCTF and the diagnoses were finally confirmed with surgery and histopathology. Multiplanar reconstruction(MPR), maximumintensity projection(MIP)and volume rendering(VR) were completed with AW Volume Share 4.2 image processing software after initial CT scanning.The internal openings, distribution, and neighboring relationship of the fistulas showed by MSCTF were analyzed and the surgical strategies were subsequently made. Results: Except 2 cases, 32 patients had obtained successfully MSCTF image. The presence and location of the fistulas could be showed clearly on MSCTF. Based on the results of MSCTF examination, the surgical planes to treat the fistulas were made. The fistulas in all cases were successfully found and excised. Three cases underwent selective neck dissection. Postoperative infection occurred in 1 case. Unilateral vocal fold paralysis due to surgery recovered 3 months after surgery with follow-up. One case lost follow-up, the remaining 33 cases were followed up for 13-97 months with no the fistula recurrence. Conclusions: MSCTF could provide valuable information and benefit surgical planning by demonstrating the coursesof congenital fistulas of neck in detail.