Congenital cysts and neck fistulas
These congenital malformations can be located in the middle or side, that is, they are medial and lateral.
If you trace the genetic pedigree in children with congenital cysts and fistula of the neck , many can identify the hereditary nature of such a pathology. Most often, inheritance occurs on a recessive basis. Despite the fact that such a pathology is considered congenital, its first signs are noted at the age of one year, 5-7 years, and also after seven years. Only occasionally dense formation near the hyoid bone is detected at an earlier age. Apparently, this is due to the deep location of the cysts and the insufficiently complete formation of the neck organs.
The emergence of cysts of the neck, usually preceded by inflammatory diseases of the upper respiratory tract or oral cavity, infection. Sometimes there are inflammatory changes in the form of an increase in cyst-like formation, painful when palpating. The median cysts and fistula of the neck are located below the hyoid bone along the midline of the neck. The cyst usually has a dense elastic consistency, it is easy to move, it is soldered to the body of the hyoid bone, which causes its displacement upward when swallowing. When the size of the cyst is large, there is a fluctuation in the liquid in it.
The lateral cyst of the neck is located at the anterior edge of the sternocleidomastoid muscle. The anterior edge of this muscle can be clearly seen when turning the head to the side. For example, if you turn your head to the right, the sternocleidomastoid muscle will be visible on the left side, and vice versa. Sometimes it is combined with other congenital anomalies: parotid fistula, underdevelopment of the auricle, deformation of the external nose. The fistula can freely open on the surface of the neck. If the cyst is opened at the stage of inflammation, then a stable fistula is formed at this place, through which the mucopurulent discharge is permanently released to the surface of the skin, due to which irritation around the fistulous course is maintained.
Operative treatment is carried out in the "cold" period, when there is no redness of the skin over the cyst and pain. Of all the existing methods of treating fistulas and cysts of L0P-organs and the neck, the most rational is surgical. However, despite the variety of the proposed methods, the frequency of recurrence of cysts and fistulas remains quite high - from 33 to 66%.Before surgery, appoint seduxen at night and in the morning( 1.5 hours before the operation), and 30 minutes before it is administered a 0.1% solution of atropine. Such measures relieve emotional tension in children, allowing the surgeon to work in a relaxed environment. Most often, the operation is performed under local anesthesia. The median cyst of the neck has thin walls, which are easily broken during the operation, contains a viscous mucous secret and even hair.
Median and lateral fistulae of the neck are more often a consequence of the breakthrough of festering cysts and rarely exist as an independent developmental defect. They are defined as a strand on the surface of the neck. The external fistula opening looks like a small gap, from which the mucopurulent content is secreted. Fistulas can be complete( with external and internal holes) and incomplete( have only an external opening).Fistula can be opened in the throat.
Additional methods of examining the child, which reliably indicate this developmental defect, are the sounding of the fistulous course, the introduction of a contrast medium with subsequent X-ray examination.
Treatment of fistula of the neck is performed only surgically.