Protection for great auricular nerve during surgery for first branchial cleft anomaly in children_West China Medical Journal

Authors：

CHEN Min ^1,2 , ZHENG Meijun ¹ ,  LI Wen ¹ , CHEN Yuezhu ¹ , YANG Liu ¹

1. Department of Otolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Otolaryngology Head & Neck Surgery, Chengdu Shangjin Nanhu Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LI Wen, Email: church.ent.wc@163.com

Keywords：

First brachial cleft anomaly; Great auricular nerve; Surgery; Function; Protection

DOI：

10.7507/1002-0179.201704191

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ObjectiveTo explore the feasibility to protect great auricular nerve during surgery for first branchial cleft anomaly in children.MethodsThe data of 17 cases of first branchial cleft cyst, sinus or fistula admitted to West China Hospital of Sichuan University from September 2005 to May 2015 were reviewed. The extent of lesion was demonstrated by enhanced CT before operation. Later surgery further proved that the middle ear and mastoid process was not involved in any of the cases. During surgery, some branches of great auricular nerve were dissected and spared. The cyst, sinus or fistula was obliterated completely while the whole or part of the parotid gland was preserved. The patients were followed-up from half a year to three years with mean time of 2 years and 1 month.ResultsNo recurrence or facial paralysis were found in all patients after surgery. Twelve patients had no paresthesia in the area innervated by great auricular nerve, five patients experienced numbness of ear lobe or inferior 1/3 of the auricle.ConclusionIt is feasible to protect some branches of great auricular nerve during the operation for first branchial cleft anomaly, which does not hinder the thoroughness of the resection for the lesion, and helps to improve the children’s quality of life.

Citation： CHEN Min, ZHENG Meijun, LI Wen, CHEN Yuezhu, YANG Liu. Protection for great auricular nerve during surgery for first branchial cleft anomaly in children. West China Medical Journal, 2018, 33(3): 321-324. doi: 10.7507/1002-0179.201704191 Copy

1.	Bajaj Y, Tweedie D, Ifeacho S, et al. Surgical technique for excision of first branchial cleft anomalies: how we do it. Clin Otolaryngol, 2011, 36(4): 371-374.
2.	Bajaj Y, Ifeacho S, Tweedie D, et al. Branchial anomalies in children. Int J Pediatr Otorhinolaryngol, 2011, 75(8): 1020-1023.
3.	D’Souza AR, Uppal HS, De R, et al. Updating concepts of first branchial cleft defects: a literature review. Int J Pediatr Otorhinolaryngol, 2002, 62(2): 103-109.
4.	胡永杰, 李亞東, 曲行舟, 等. 鰓裂囊腫 (瘺)284 例臨床分析. 上海口腔醫學, 2008, 17(5): 461-464.
5.	高燕, 李文, 易雪蓮, 等. 腮腺腫瘤術中保留耳大神經分支的臨床分析. 華西醫學, 2015, 30(1): 100-101.
6.	盧永田, 苗北平, 許安廷. 第一鰓裂囊腫及瘺管的診斷治療. 山東大學耳鼻喉眼學報, 2007, 21(5): 456-458.
7.	楊長東, 馮凌, 馬泓智, 等. 面神經解剖腮腺部分切除治療第一鰓裂瘺管. 中華耳科學雜志, 2012, 10(3): 338-339.
8.	Chan KC, Chao WC, Wu CM. Surgical management of first branchial cleft anomaly presenting as infected retroauricular mass using a microscopic dissection technique. Am J Otolaryngol, 2011, 33(1): 20-25.
9.	何慧媛, 趙昱, 陳曉棟, 等. 面神經監護在復雜第一鰓裂瘺切除術中的應用. 現代口腔醫學雜志, 2013, 27(4): 196-199.
10.	張光平, 錢靜, 陳穎坤, 等. 面神經解剖在第一鰓裂瘺管切除術中的意義. 中國耳鼻咽喉顱底外科雜志, 2008, 14(1): 32-34.
11.	黃超洋, 謝壯志, 沈國民, 等. 面神經解剖切除復發性第一鰓裂瘺的治療體會. 臨床耳鼻咽喉頭頸外科雜志, 2008, 22(7): 330-330.
12.	孔旭輝, 鮑學禮, 黃永久, 等. 先天性第一鰓裂瘺 14 例報告. 中華耳科學雜志, 2007, 5(2): 186-188.
13.	李波, 鄒劍, 鄭虹, 等. 第一鰓裂瘺管切除術中面神經解剖的臨床意義. 中國耳鼻咽喉頭頸外科, 2012, 19(4): 179-181.
14.	Yang HM, Kim HJ, Hu KS. Anatomic and histological study of great auricular nerve and its clinical implication. J Plast Reconstr Aesthet Surg, 2015, 68(2): 230-236.
15.	George M, Karkos PD, Dwivedi RC, et al. Preservation of greater auricular nerve during parotidectomy: sensation, quality of life, and morbidity issues. A systematic review. Head Neck, 2014, 36(4): 603-608.

1. Bajaj Y, Tweedie D, Ifeacho S, et al. Surgical technique for excision of first branchial cleft anomalies: how we do it. Clin Otolaryngol, 2011, 36(4): 371-374.
2. Bajaj Y, Ifeacho S, Tweedie D, et al. Branchial anomalies in children. Int J Pediatr Otorhinolaryngol, 2011, 75(8): 1020-1023.
3. D’Souza AR, Uppal HS, De R, et al. Updating concepts of first branchial cleft defects: a literature review. Int J Pediatr Otorhinolaryngol, 2002, 62(2): 103-109.
4. 胡永杰, 李亞東, 曲行舟, 等. 鰓裂囊腫 (瘺)284 例臨床分析. 上海口腔醫學, 2008, 17(5): 461-464.
5. 高燕, 李文, 易雪蓮, 等. 腮腺腫瘤術中保留耳大神經分支的臨床分析. 華西醫學, 2015, 30(1): 100-101.
6. 盧永田, 苗北平, 許安廷. 第一鰓裂囊腫及瘺管的診斷治療. 山東大學耳鼻喉眼學報, 2007, 21(5): 456-458.
7. 楊長東, 馮凌, 馬泓智, 等. 面神經解剖腮腺部分切除治療第一鰓裂瘺管. 中華耳科學雜志, 2012, 10(3): 338-339.
8. Chan KC, Chao WC, Wu CM. Surgical management of first branchial cleft anomaly presenting as infected retroauricular mass using a microscopic dissection technique. Am J Otolaryngol, 2011, 33(1): 20-25.
9. 何慧媛, 趙昱, 陳曉棟, 等. 面神經監護在復雜第一鰓裂瘺切除術中的應用. 現代口腔醫學雜志, 2013, 27(4): 196-199.
10. 張光平, 錢靜, 陳穎坤, 等. 面神經解剖在第一鰓裂瘺管切除術中的意義. 中國耳鼻咽喉顱底外科雜志, 2008, 14(1): 32-34.
11. 黃超洋, 謝壯志, 沈國民, 等. 面神經解剖切除復發性第一鰓裂瘺的治療體會. 臨床耳鼻咽喉頭頸外科雜志, 2008, 22(7): 330-330.
12. 孔旭輝, 鮑學禮, 黃永久, 等. 先天性第一鰓裂瘺 14 例報告. 中華耳科學雜志, 2007, 5(2): 186-188.
13. 李波, 鄒劍, 鄭虹, 等. 第一鰓裂瘺管切除術中面神經解剖的臨床意義. 中國耳鼻咽喉頭頸外科, 2012, 19(4): 179-181.
14. Yang HM, Kim HJ, Hu KS. Anatomic and histological study of great auricular nerve and its clinical implication. J Plast Reconstr Aesthet Surg, 2015, 68(2): 230-236.
15. George M, Karkos PD, Dwivedi RC, et al. Preservation of greater auricular nerve during parotidectomy: sensation, quality of life, and morbidity issues. A systematic review. Head Neck, 2014, 36(4): 603-608.

West China Medical Journal

Protection for great auricular nerve during surgery for first branchial cleft anomaly in children

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