第一腮裂竇造成外耳道狹窄－病例報告

第一鰓裂異常相當少見，僅佔所有鰓裂異常的1%，其診斷則有賴於對此病的充分瞭解。第一鰓裂異常可形成囊腫、竇或廔管，源起於鰓裂遺跡構造的不完全消退。此病可發現於各年齡層，症狀多變化；非慢性或急性中耳炎而有持續或復發的耳漏或耳道口旁廔管，經多次治療仍持續存在，或耳後、耳下、下颌角後有囊腫或廔管開口，應懷疑本症。治療原則為完全切除。病例為6歲3月大的男童，因左耳後乳突紅腫疼痛至本院求診。檢查時發現同時有外耳道狹窄，故以為是狹窄引起的外耳道發炎或膿瘍。手術卻發現有另一與原外耳道相鄰、平行而相通，且含多方向盲端的不規則狀竇。我們將內部角質物取出，將不規則盲端的表皮除去，並將其與外耳道之間的軟骨壁及皮膚切除。術後追蹤21個月，至今無復發或外耳道狹窄。

關鍵字

第一鰓裂竇；顏面神經；外耳道狹窄

並列摘要

First branchial cleft anomalies, which include cysts. Sinuses. and fistulae. are rarely encountered in otological practice. They comprise only 1% of all branchial cleft anoma-lies. Straightforward diagnosis is usually difficult because various clinical manifesta-tions may occur in the external ear canal, around the auricle, or even in the parotid gland. In this paper, we report on a 6-year-old boy who presented with long-term left external ear canal stenosis and a recently-developed painful postauricular swelling. Computed tomographic scanning revealed an abscess near the mastoid process. During surgery, a cystic tract with keratin content and epithelial lining was noted extending parallel and inferior to the external ear canal. The cyst-like sinus had a small connection with the external ear canal at the stenotic site. The sinus was excised and the stenosis widened. No recurrence of stenosis and infection has been noted 21 months after the operation. From our experience with this extremely rare case, we suggest that surgery is the only way to obtain a correct diagnosis and cure of first branchial cleft anomalies.

並列關鍵字

first branchial cleft sinus ； facial nerve ； extemal auditory canal stenosis

國際替代計量

第一腮裂竇造成外耳道狹窄－病例報告

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