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Wang FJ, Xu F, Xiao LH, Qin F, Zhang LH, Wang L, Qi XQ, Weng CY. Ultrasound diagnosis and treatment of branchial cleft cyst and preoperative management. Eur Arch Otorhinolaryngol 2024; 281:419-425. [PMID: 37673830 DOI: 10.1007/s00405-023-08209-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE The ultrasonic diagnosis of cervical and facial cystic masses, as well as cases of missed diagnosis and misdiagnosis, was examined, to improve the diagnosis of branchial cleft anomalies. METHODS A retrospective analysis was conducted on 17 patients with branchial cleft cyst anomalies, including 11 males and 6 females, aged 12-53 years, with an average age of 33 ± 2 years, were unilateral single. All patients who underwent an ultrasound examination and image storage for retrospective analysis, and both longitudinal and transverse sections were scanned to observe the shape, size, boundary, peripheral relationship, and blood flow signal of the masses. All cases were examined with an enhanced CT scan, and pathological reports were generated. RESULTS Among the 17 cases of branchial cleft anomalies, 15 cases were branchial cleft cysts, while one case involved fistula formation and one case involved sinus tract formation. Based on the type of branchial cleft, the first, second, and third cysts were classified in 4, 12, and 1 case, respectively. The sensitivity rate and specificity of ultrasonic diagnosis were 14/17 (82.4%) and 4/6 (66.7%), respectively. Ultrasonic characteristic analysis for the masses can be found in simple cystic masses or hypoechoic masses, most of them are of a regular shape and have a distinct boundary, and almost no blood flow signal. All patients who were misdiagnosed exhibited blood flow signals, including 1 patient with an abundant blood flow signal, 1 patient suspected of having ectopic thyroid with an abnormal function due to the rat-tail sign, 2 patients misdiagnosed as local inflammatory focus, and 1 patient misdiagnosed with tuberculous lymphadenitis. CONCLUSION Ultrasound has a detection rate of up to 100% for cervical and facial masses, providing a fundamental determination of lesion characteristics and specific guidance for preoperative diagnosis. If the blood flow signals can be identified and carefully considered their peripheral relationship, the diagnostic rate can be improved.
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Affiliation(s)
- Fu-Jian Wang
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China
| | - Fang Xu
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China
| | - Li-Hua Xiao
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China
| | - Feng Qin
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China
| | - Li-Hong Zhang
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China
| | - Li Wang
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China
| | - Xiao-Qing Qi
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China.
| | - Chao-Yang Weng
- Department of Ultrasound, The Ninth People's Hospital of Hangzhou, No. 98 of Yi-Rong Road, Yi-PengStreet, QianTANG District, Hangzhou, 311225, Zhejiang, China.
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