Діагностичні аспекти бічних кіст шиї

Abstract

В статье приведены результаты собственных клинических наблюдений и цитологического исследования содержимого кист боковой области шеи. Определена диагностическая информативность клеточного состава пунктата, который получали под контролем ультразвукового исследования. На основании сравнительного анализа данных показателей установлено, что в этой области могут локализоваться кисты различного происхождения: бранхиогенные, дермоидные, эпидермоидные и кисты слюнных желез. Set the early signs of fetal cysts maxillofacial area is difficult. Usually, they are randomly or during festering that occurs most often after activation of trigger factors, such as ARVI or hypothermia. Clinically, cysts lateral neck area – the formation of painful round or oval, dense consistency. The skin over them in color is not changed, congestion occurs only when you connect to a secondary infection. Their necks differential diagnosis should be made with chronic lymphadenitis (specific and nonspecific), benign or malignant tumors or tumor formations like the soft tissues of the neck, blood vessels, nerves and metastases. Large cysts likelihood of malignancy lateral neck area as branhiohenic cancer that is found in 4.5% of patients with lateral neck cysts. The complexity of diagnosis and a high percentage of cases of malignancy leads to greater involvement in the diagnostic management of simple but informative methods. The aim was to determine the effectiveness. Fine needle aspiration biopsy to improve diagnostic measures and choice of treatment of cysts of the lateral neck area. Material and methods. General survey methods included the careful complaints installation and life history of the disease, patient examination, determination of disease duration and characteristics of its flow. Evaluated the shape, color of skin and tissue turgor in the seat projection cysts determined size, sharpness of contours, ratio of sternumclavicular-mastoid muscle, consistency, cohesion with the surrounding tissues. Clinical observations concerning 89 patients with bone lateral neck area aged 13 to 65 years. Of them men – 42 (47.2%), women – 47 (52.8%). Analysis of the data revealed that the peak incidence at age cyst of lateral area of neck – its patients from 21 to 35 years, that mature age of first period by age World Health Organization classification. Localized cystic formation often left – 56 patients (62.9%), right – 33 patients (37.1%). According to the survey algorithm developed by us cyst of lateral area neck all patients were divided into groups: the first is represented by 27 patients (30.3%) its branhiohenic cyst of neck, the second included – 23 patients (25.8%) of epidermoid cyst of the lateral area neck, third – 24 patients (27%) of dermoid cyst of the lateral areas of the neck, the fourth – 15 patients (16.9%) of salivary gland cyst. This was confirmed after examining cytological punctate pattern and conducted ultrasound examinations. After studying the cellular composition punctate at the prehospital is reasonable for distribution to branhiohenic cysts, dermoid, epidermoid cysts and salivary glands cysts, allowing you to decide on further treatment tactics. When festering cystic formations in most cases can eliminate the effects of inflammation conservative methods, and only 2.3% of cases, patients required surgery and concerned a dermoid cyst.