Neck fistula and cyst, lateral Q18.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Congenital cheek fistula; Cyst thymic; lateral congenital fistula; Neck cyst; Neck Fistula

History
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Hunczovsky, 1785; Ascherson, 1832

Definition
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Branchial fistula or cyst derived from the second gill cleft and caused by an insufficient regression of the ductus thymopharyngeus.

Localization
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Originating on a line that connects the mandibular angle with the manubrium sterni.

Clinical features
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Outer opening: Anterior edge of the sternocleidomastoid muscle, approximately at laryngeal level. The duct runs above the carotid bifurcation and opens above the palatal tonsil into the recessus supratonsillaris. Mostly blind end in the lateral pharyngeal wall.

Therapy
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Complete extirpation of the fistula or cyst with capsule from school age onwards in cooperation with ENT colleagues or the oral-jaw surgeon. Follow-up of the course, if necessary intraoperatively with dye solutions such as methylene blue. Persistent cysts often lead to recurrences. In case of inflammation antibiotic pre-treatment usually with ampicillin (e.g. Ampicillin Wolff Filmtbl.).

Progression/forecast
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Recurrence rate about 2%.

Literature
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  1. Eustachi B (1564) Opuscula Anatomica. Vincentius Luchinus excudebat (Venice).
  2. Hunczovsky JN (1785) Instruction on surgical operations. Intended for his lectures. R. Gräffer (Vienna)
  3. Nakano M et al (1999) Congenital cheek fistula: a report of three cases. Br J Plast Surgery 52: 311-313
  4. Nicollas R et al (2000) Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol 55: 117-124
  5. Zou F et al (2003) A locus for congenital preauricular fistula maps to chromosome 8q11.1-q13.3 J Hum Genet 48: 155-158

Outgoing links (4)

Ampicillin; Antibiotics; Cyst; Fistula;

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020