先天性側頸部瘻管及び〓腫に関する考察

抄録

Lateral cervical fistulas and cysts are thought to be derived from bronchial cleft remnants, but there are still disputes as to the exact etiology of these anomalies.
In order to obtain better understanding con- cerning the pathogenesis and varieties of clinical manifestations, correlation between the embryo- logy of the branchial clefts and clinical pictures are required.
Using nine human embryos, ranging between 8 mm to 50 mm in size, development and disap- pearance of branchial cleft structures were obser- ved. Anatomical features of the fistulas derived from each cleft remnant were discussed.
Concerning the pathogenesis of this anomalies, numerous theories has been proposed. In spite of exhaustive research work of Wengelowski, his thymic duct theory has its weakness and is largely abandoned at present. Frazer's suggestion con- cerning its etiology is most convincing, in which he maintains that fistulas and cysts are derived from any one of numerous lateral vestigial struc- tures of the neck.
Reviewing cases appeared in the world litera- ture, the author tried to classify the fistulas and cysts according to the first through the fourth cleft origin. Although the second cleft anomaly is the most common one, the first and the third cleft anomalies must be taken into consideration. Anomalies of the first and the third cleft are re- ported from the author's experience,
Related anomalies and differential diagnosis were reviewed briefly.