1/9. Innovation and surgical techniques: endoscopic resection of cervical branchiogenic cysts.The recent advent of endoscopic procedures has compelled both plastic and neck and head surgeons to reconsider the conventional methods by which the excision of cervical congenital cystic is classically achieved.An endoscopic approach for excision of the cervical congenital cystic is described. This procedure is anatomically safe and can be made with minimal morbidity through a small transcervical incision.Both specific instruments and solid anatomical knowledge are necessary to perform a safe and efficient cystic endoscopic excision.The essential surgical steps are as follows: 1. Minimal incision placed in natural cervical wrinkle over the dome of the cyst; 2. Intracystic or extracystic dissection; 3. Identification and protection of the sternocleidomastoid muscle, spinal nerve, hypoglossi nerve, and posterior belly of digastric muscle; 4. Careful dissection of the posterior surface of the cyst, avoiding injury on the carotid vessels and internal jugular vein.Eight patients were operated on with this technique and they were very pleased with postoperative comfort and aesthetic results. Inconspicuous scars and no complications were registered.With advanced endoscopic instruments and the development of new surgical technique and surgeon experience, the endoscopic surgery can be the method of choice in cervical excision of branchiogenic cysts.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Parapharyngeal branchial cleft cyst extending to the skull base: a lateral transzygomatic-transtemporal approach to the parapharyngeal space.Second branchial cleft cysts (BCCs) can occur anywhere from the tonsillar fossa to the supraclavicular area. Second BCCs usually lie on the great vessels of the neck, deep in the sternocleoidomastoid muscle or along its anterior border at the mandibular angle. Parapharyngeal second BCCs are an uncommon neoplasm and rarely extend to the skull base. We report the case of a 45-year-old male with symptoms of conductive hearing loss. temporal bone CT scan showed effusion in the left middle ear cavity. magnetic resonance imaging (MRI) revealed a cystic mass that was located at the left parapharyngeal space and eroded the skull table of the left temporal base. Excision of the lesion was achieved via a transzygomatic-transtemporal approach to the parapharyngeal space. Histopathological examination of the cyst wall showed a single layer of ciliated columnar epithelium without goblet cells or lymphoid tissue. The patient recovered without any complications and experienced complete resolution of left-sided hearing difficulty. We conclude the lateral transzygomatic-transtemporal approach allows surgeons direct access to the parapharyngeal space with satisfactory exposure for treating benign lesions of the parapharyngeal space.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/9. Angiographic features of lateral cervical masses.An audible bruit may represent a clue to the vascular nature of the lesion. angiography is definitely indicated in the presence of pulsatile cervical masses with or without an associated bruit, and should be more widely utilized in the future for evaluation of cervical masses. In addition to the nature of the mass, angiography may also be of value in outlining the extent of the mass and its relationship to major vessels. Magnification and subtraction angiographic techniques with their improved detail may play an important role in clarifying the etiology of cervical masses, and hence facilitate the plan of therapy. If reasonable uncertainty as to the clinical diagnosis exists, angiography should be considered a diagnostic aid.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Carotid arteriospasm.Arteriospasm can result from manipulation or fresh blood around an artery. This myogenic reflex can spread to obliterate collateral flow and can last from minutes to days. Ischemic strokes from carotid spasm ensue neurosurgical procedures, endarterectomies, and even chiropractic manipulation. The diagnosis and prevention of arteriospasm are presented, and a patient who has carotid arteriospasm following excision of a branchial cleft cyst is detailed. If the vessel constriction is noted at surgery, topical application of a local anesthetic is effective. Transfusion, hydration, oxygenation, and maintenance of blood pressure are the cornerstones of nonoperative therapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/9. Approaches to the diagnosis and treatment of tumors of the parapharyngeal space.Tumors of the parapharyngeal space appear as painless massess bulging into the tonsillar, nasopharyngeal, or retromandibular area. Most are benign and represent a wide range of tumor growth, from parotid extension to intrinsic growth of nerves, blood vessels, and salivary gland tissues within or around the parapharyngeal area. The anatomy of this area and diagnostic procedures are discussed. Sinus films, tomograms of the skull base and lateral pharyngeal area, CT scans with simultaneous parotid sialograms, and angiograms are part of the evaluation of these rarely seen tumors. The approach to therapy is discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/9. The fourth branchial cleft anomaly.The fourth branchial cleft anomaly has long been postulated. A case in which a lower neck sinus tract extended under the clavicle near the subclavian vessels is presented. The distinguishing features of bronchogenic and branchogenic anomalies are discussed. It appears that unless a complication (e.g., abscess, inflammatory process) of the fourth branchial cleft sinus tract occurs within the mediastinum, mandating full exploration, the complete form of the anomaly may continue to remain undocumented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/9. Thymopharyngeal duct cyst: MR imaging of a third branchial arch anomaly in a neonate.Third branchial arch anomalies are rare. The authors present a case report of a neonate with a rapidly growing neck mass due to cystic dilation of a persistent thymopharyngeal duct, which is a derivative of the third branchial arch. The presence of thyroid and thymic tissue in the cyst wall, the communication of the cyst with the piriform sinus, and the relationship of the cyst to carotid vessels and the sternomastoid muscle were consistent with the features of a thymopharyngeal duct cyst embedded in the thyroid gland.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Branchial cleft cyst posterior to the carotid vessels.Branchial cleft anomalies may appear as a sinus fistula or cyst. An understanding of the developmental embryology and anatomy can predict branchial cleft anomalies by the relationship of the corresponding branchial arches that form at the time of development. The second branchial cleft anomalies are the most common and may be found along a tract from the anterior border of the sternocleidomastoid muscle anterior to the carotid vessels and IX and XII. A cyst may form anywhere along this tract but most commonly is just lateral to the internal jugular vein anterior to the carotid vessels. We describe a patient with a second branchial cleft cyst that was posterior to the carotid vessels documented by computed tomography. The cyst was found intraoperatively to be clearly posterior to the common carotid artery. This case demonstrates the need for an understanding of developmental embryology, anatomical landmarks and variations.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
9/9. Pharyngeal localizations of branchial cysts.Two cases with unusual pharyngeal localizations of branchial cysts medial to the great neck vessels and pharyngeal constrictor muscle are presented. The authors reviewed the theories of origin of the branchial cysts and the surgical treatment options. In their first case the transoral approach was chosen. Because of previous unsuccessful attempts at surgical treatment, the pharyngeal cyst was extremely adherent to adjacent tissue with much scar tissue, and it was very difficult to remove. As a result of this disappointing operation, an external neck exploration was indicated in the second patient. Histological examinations confirmed that the excised cysts were branchial in both cases.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |