Relationship between Work Ⅱ type of congenital first branchial cleft anomaly and facial nerve and surgical strategies

Bei Zhang; Liangsi Chen; Shuling Huang; Lu Liang; Xixiang Gong; Peina WU; Siyi Zhang; Xiaoning Luo; Jiandong Zhan; Xiaoli Sheng; Zhongming LU

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Relationship between Work Ⅱ type of congenital first branchial cleft anomaly and facial nerve and surgical strategies

VernacularTitle: Work Ⅱ型先天性第一鳃裂畸形与面神经解剖关系研究及外科策略
Author: Bei ZHANG ¹ ; Liangsi CHEN ¹ ; Shuling HUANG ¹ ; Lu LIANG ² ; Xixiang GONG ; Peina WU ¹ ; Siyi ZHANG ¹ ; Xiaoning LUO ¹ ; Jiandong ZHAN ¹ ; Xiaoli SHENG ¹ ; Zhongming LU ¹
Author Information

1. Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 511080, China
2. Department of Otorhinolaryngology, First People′s Hospital of Guangzhou, Guangzhou 510180, China
Publication Type:Journal Article
Keywords: Congenital abnormalities; Branchial region; Facial nerve; Myringeal web
From: Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2017;52(10):760-765
CountryChina
Language:Chinese
Abstract: Objective:To investigate the relationship between Work Ⅱ type of congenital first branchial cleft anomaly (CFBCA) and facial nerve and discuss surgical strategies.
Methods:Retrospective analysis of 37 patients with CFBCA who were treated from May 2005 to September 2016. Among 37 cases with CFBCA, 12 males and 25 females; 24 in the left and 13 in the right; the age at diagnosis was from 1 to 76 ( years, with a median age of 20, 24 cases with age of 18 years or less and 13 with age more than 18 years; duration of disease ranged from 1 to 10 years (median of 6 years); 4 cases were recurren after fistula resection. According to the classification of Olsen, all 37 cases were non-cyst (sinus or fistula). External fistula located over the mandibular angle in 28 (75.7%) cases and below the angle in 9 (24.3%) cases.
Results:Surgeries were performed successfully in all the 37 cases. It was found that lesions located at anterior of the facial nerve in 13 (35.1%) cases, coursed between the branches in 3 cases (8.1%), and lied in the deep of the facial nerve in 21 (56.8%) cases. CFBCA in female with external fistula below mandibular angle and membranous band was more likely to lie deep of the facial nerve than in male with external fistula over the mandibular angle but without myringeal web.
Conclusions:CFBCA in female patients with a external fistula located below the mandibular angle, non-cyst of Olsen or a myringeal web is more likely to lie deep of the facial nerve. Surgeons should particularly take care of the protection of facial nerve in these patients, if necessary, facial nerve monitoring technology can be used during surgery to complete resection of lesions.