갈라진 귓볼과 동반된 양측성 선천성 누낭 피부누공의 경험례

A Case Report of Bilateral Congenital Lacrimal Sac Fistula with Cleft Ear Lobe

  • 이한정 (순천향대학교 의과대학 성형외과학교실) ;
  • 최환준 (순천향대학교 의과대학 성형외과학교실) ;
  • 최창용 (순천향대학교 의과대학 성형외과학교실)
  • Lee, Han Jung (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Chang Yong (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 투고 : 2007.12.17
  • 심사 : 2008.02.14
  • 발행 : 2008.03.10

초록

Purpose: A congenital lacrimal sac fistula is unusual and consists of a dimple opening below the medial canthal tendon that leads to the lacrimal sac. This anlage ducts occur when the lacrimal anlage cells proliferate and canalize rather than involute. And, the anomaly is usually not associated with any systemic abnormalities. Also congenital cleft of the earlobes is rarely seen among congenital ear anomalies. Therefore, we report rare case with symptomatic bilateral lacrimal fistula with the ear cleft. Methods: A 4-year-old boy was admitted with aggravated chronic maxillary sinusitis, recurrent chronic dacryocystitis, and epiphora. He had two minor anomalies including bilateral lacrimal fistula originated in lacrimal tear sac and unilateral transverse ear cleft. The patient had been operated with fistulectomy and perioperative antibiotics. A small vertical ellipse is made around the opening with sharp dissection. The tract is excised using the probe as the guide. Another probe is placed through the lower canaliculus to prevent the damage. A suture ligature of 6-0 Maxon is placed around the deepest point of the tract, which is then excised. Additional sutures are placed in the tissues to form a tight closure to prevent reestablishment of the fistula. The skin is closed with 6-0 Black Silk. Results: The patient recovered well without any complications such as infection, epiphora, and obstruction of lacrimal sac. Conclusion: Our case illustrates bilateral lacrimal anlage ducts in a patient with unilateral congenital ear cleft. We recommend careful evaluation of lacrimal system in these patients, especially bilateral case and other congenital anomalies. Finally, we recommend excision of the ducts when epiphora, infection, or chronic skin irritation occur.

키워드

참고문헌

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