目的:本研究的目的是探讨胸锁关节区先天性胸锁窦的临床诊断和治疗。为儿童临床实践提供有价值的见解。
方法:在2022年1月至2023年9月的三级护理儿科耳鼻喉科实践中,对所有接受先天性胸锁窦治疗的患者进行了病例记录的回顾性回顾。这篇综述分析了临床表现,影像学检查,病理检查,和治疗。
结果:共有56例先天性胸锁窦患者被纳入研究,平均年龄4.10±2.57岁。在这些患者中,43例鼻窦位于左侧,在12例的右侧,在一个案例中,双边。虽然两名患者从未经历过炎症,54名患者这样做,其中45例切除前行切开引流。影像学检查,包括超声和计算机断层扫描,揭示了皮下组织增厚等特征,锁骨前方的皮下管状结构或结节,和不规则形状的病变,边界清晰,内部低回声不均匀,病理检查证实所有患者的鼻窦均为鳞状上皮。
结论:先天性胸锁窦可能是皮肤侧第4支裂隙的残余部分。在炎症的静止阶段完全切除鼻窦是推荐的治疗方法,以防止反复感染。
OBJECTIVE: The objective of this study is to explore the clinical diagnosis and treatment of the congenital sternoclavicular
sinus in the region of sternoclavicular joint, providing valuable insights for clinical practice in children.
METHODS: A retrospective review of case notes was conducted for all patients treated for congenital sternoclavicular
sinus at a tertiary care pediatric otolaryngology practice from January 2022 to September 2023.This review analyzed the clinical presentations, imaging examination, pathological examination, and treatment.
RESULTS: A total of 56 patients with congenital sternoclavicular
sinus were included in the study, with a mean age of 4.10 ± 2.57 years old. Among these patients, the sinuses were located on the left side in 43 cases,on the right side in 12 cases,and bilaterally in one case.While two patients never experienced inflammation, 54 patients did, and 45 of them underwent incision and drainage before excision. Imaging examination, including ultrasonography and computerized tomography (CT) scans, revealed characteristics such as thickening of subcutaneous tissue,subcutaneous tubular structures or tubercles in front of the clavicle,and irregularly shaped lesions with clear borders and uneven internal low echo, Pathological examination confirmed that the sinuses were lined by squamous epithelium in all patients.
CONCLUSIONS: The congenital sternoclavicular
sinus may be a remnant of the fourth branchial cleft on the skin side.Complete resection of the
sinus during the quiescent phase of inflammation is the recommended curative treatment to prevent recurrent infection.