PDF(Pubmed)
Abstract：
A congenital cheek fistula is a rare malformation in the buccal area. Here, we report the case of a congenital cheek fistula in a 50-year-old woman who visited our clinic with complaints of swelling and pain in her left cheek. Physical examination revealed a small hole in the left corner of the mouth present since birth. She had no other congenital malformations in the maxillofacial region such as an accessory ear and cleft lip. Manual compression of the cheek mass induced serous discharge from the hole. Magnetic resonance imaging (MRI) showed a cystic lesion in the left cheek and a fistula within the orbicularis oris muscle that opened into the small hole. After immediate incision and drainage of the cyst, both the cyst and fistula were surgically resected. The cystic lesion was completely delineated from the boundary of the parotid gland. The orbicularis oris muscle was partially incised to remove the fistula and the surrounding scar tissue. Histopathological examination of the resected specimen revealed a cavity consisting of epithelium inside the fistula. The postoperative course was insignificant. No recurrence of the cyst was observed six months postoperatively. The operative and pathological findings demonstrated that the ectoderm-derived epithelial tissue was enclosed by the mesoderm-derived muscle tissue. The mixture of different germ layer-derived tissues suggested that the fistula was a type of congenital transverse facial cleft induced by malfusion of the mandibular and maxillary prominences during embryonic development. The differential diagnoses of the congenital cheek fistula included orocutaneous fistulas and salivary fistulas. MRI was useful in delineating the border between the lesion and the surrounding tissue.
摘要：
先天性颊瘘是颊部罕见的畸形。这里,我们报告了一例50岁女性先天性颊瘘的病例，她到我们的诊所就诊，主诉她的左脸颊肿胀和疼痛。体格检查发现，自出生以来，嘴的左角有一个小孔。她在颌面部区域没有其他先天性畸形，例如副耳和唇裂。手动压缩颊块会引起浆液性从孔排出。磁共振成像（MRI）显示左脸颊有囊性病变，口轮匝肌内有一个瘘管，该瘘管通向小孔。立即切开并引流囊肿后，囊肿和瘘管均通过手术切除。囊性病变完全从腮腺的边界划定。部分切开口轮匝肌，以去除瘘管和周围的疤痕组织。切除标本的组织病理学检查显示，瘘管内有一个由上皮组成的腔。术后病程不明显。术后6个月无囊肿复发。手术和病理结果表明，外胚层来源的上皮组织被中胚层来源的肌肉组织所包围。不同胚层来源组织的混合物表明，瘘管是一种先天性横向面部裂隙，是在胚胎发育过程中下颌和上颌突出部融合不良引起的。先天性颊瘘的鉴别诊断包括皮肤瘘和唾液瘘。MRI可用于描绘病变与周围组织之间的边界。
