Abstract：
OBJECTIVE: We encountered patients with a congenital cutaneous sinus tract in the sternoclavicular joint region, which we designate as \"congenital sternoclavicular sinus (CSCS).\" The aim of this investigation is to enhance recognition of this subtle yet noteworthy entity and develop standardized protocols for its management.
METHODS: Between 2013 and 2023, 172 patients, including 78 males and 94 females, were referred to our institution for the management of CSCS. Clinical charts were retrospectively reviewed.
RESULTS: The majority of patients (60.5%) were young children below 3 years of age, with only six adult patients and a median age of 27.5 months. The left side was implicated in 157 cases (91.3%). In 146 cases (84.9%), a faint skin streak was noted above the orifice. Yet, no pharyngeal sinus tracts were detected, either through barium swallow studies or direct laryngoscopy. All skin lesions featured a diminutive orifice near the sternoclavicular joint, with the tract extending deeply into the subcutaneous tissue and terminating blindly, short of entering the joint, after a distance of 10 mm (ranging from 5 to 21 mm). Histopathological analysis revealed that the epithelial lining predominantly consisted of stratified squamous epithelium (87.8%), with ciliated columnar epithelium accounting for the remaining 12.2%.
CONCLUSIONS: CSCS, though infrequent, presents with distinctive pathological and clinical features. The condition predominantly affects the left sternoclavicular joint region, with the notable \"skin streak sign\" aiding in diagnosis. We considered CSCS as one disease entity of branchial arch anomalies. Complete surgical excision offers a definitive cure.
METHODS: 4 Laryngoscope, 2024.
METHODS: Between 2013 and 2023, 172 patients, including 78 males and 94 females, were referred to our institution for the management of CSCS. Clinical charts were retrospectively reviewed.
RESULTS: The majority of patients (60.5%) were young children below 3 years of age, with only six adult patients and a median age of 27.5 months. The left side was implicated in 157 cases (91.3%). In 146 cases (84.9%), a faint skin streak was noted above the orifice. Yet, no pharyngeal sinus tracts were detected, either through barium swallow studies or direct laryngoscopy. All skin lesions featured a diminutive orifice near the sternoclavicular joint, with the tract extending deeply into the subcutaneous tissue and terminating blindly, short of entering the joint, after a distance of 10 mm (ranging from 5 to 21 mm). Histopathological analysis revealed that the epithelial lining predominantly consisted of stratified squamous epithelium (87.8%), with ciliated columnar epithelium accounting for the remaining 12.2%.
CONCLUSIONS: CSCS, though infrequent, presents with distinctive pathological and clinical features. The condition predominantly affects the left sternoclavicular joint region, with the notable \"skin streak sign\" aiding in diagnosis. We considered CSCS as one disease entity of branchial arch anomalies. Complete surgical excision offers a definitive cure.
METHODS: 4 Laryngoscope, 2024.
摘要：
目的：我们遇到了胸锁关节区先天性皮肤窦道的患者，我们称之为“先天性胸锁窦(CSCS)”。这项调查的目的是提高对这个微妙但值得注意的实体的认识，并为其管理制定标准化协议。
方法：在2013年至2023年之间，172名患者，包括78名男性和94名女性，被转介给我们的CSCS管理机构。回顾性分析临床图表。
结果：大多数患者（60.5%）是3岁以下的幼儿，只有6名成年患者，中位年龄为27.5个月。左侧牵连157例(91.3%)。146例（84.9%），孔上方有微弱的皮肤条纹。然而，没有检测到咽窦道,通过钡吞咽研究或直接喉镜检查。所有皮肤损伤都以胸锁关节附近的小孔口为特征，管道深入皮下组织并盲目终止，除了进入关节外，后10毫米的距离（范围从5到21毫米）。组织病理学分析显示，上皮内衬主要由复层鳞状上皮组成（87.8%），纤毛柱状上皮占其余12.2%。
结论：CSCS，虽然不常见，具有独特的病理和临床特征。病情主要影响左胸锁关节区域，带有明显的“皮肤条纹征”帮助诊断。我们认为CSCS是支气管弓异常的一种疾病实体。完整的手术切除提供了明确的治疗方法。
方法：4喉镜，2024.
方法：在2013年至2023年之间，172名患者，包括78名男性和94名女性，被转介给我们的CSCS管理机构。回顾性分析临床图表。
结果：大多数患者（60.5%）是3岁以下的幼儿，只有6名成年患者，中位年龄为27.5个月。左侧牵连157例(91.3%)。146例（84.9%），孔上方有微弱的皮肤条纹。然而，没有检测到咽窦道,通过钡吞咽研究或直接喉镜检查。所有皮肤损伤都以胸锁关节附近的小孔口为特征，管道深入皮下组织并盲目终止，除了进入关节外，后10毫米的距离（范围从5到21毫米）。组织病理学分析显示，上皮内衬主要由复层鳞状上皮组成（87.8%），纤毛柱状上皮占其余12.2%。
结论：CSCS，虽然不常见，具有独特的病理和临床特征。病情主要影响左胸锁关节区域，带有明显的“皮肤条纹征”帮助诊断。我们认为CSCS是支气管弓异常的一种疾病实体。完整的手术切除提供了明确的治疗方法。
方法：4喉镜，2024.
