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Objectives: We encountered patients with a congenital cutaneous sinus tract in the sternoclavicular joint region, which we designate as "congenital sternoclavicular sinus (CSCS)." The aim of this investigation is to enhance recognition of this subtle yet noteworthy entity and develop standardized protocols for its management. Patients and Methods: Between 2013 and 2023, 172 patients, including 78 males and 94 females, were referred to our institution for the management of CSCS. Clinical charts were retrospectively reviewed. Results: The majority of patients (60.5%) were young children below 3 years of age, with only six adult patients and a median age of 27.5 months. The left side was implicated in 157 cases (91.3%). In 146 cases (84.9%), a faint skin streak was noted above the orifice. Yet, no pharyngeal sinus tracts were detected, either through barium swallow studies or direct laryngoscopy. All skin lesions featured a diminutive orifice near the sternoclavicular joint, with the tract extending deeply into the subcutaneous tissue and terminating blindly, short of entering the joint, after a distance of 10 mm (ranging from 5 to 21 mm). Histopathological analysis revealed that the epithelial lining predominantly consisted of stratified squamous epithelium (87.8%), with ciliated columnar epithelium accounting for the remaining 12.2%. Conclusions: CSCS, though infrequent, presents with distinctive pathological and clinical features. The condition predominantly affects the left sternoclavicular joint region, with the notable "skin streak sign" aiding in diagnosis. We considered CSCS as one disease entity of branchial arch anomalies. Complete surgical excision offers a definitive cure. Level of Evidence: 4 Laryngoscope, 134:4402–4408, 2024 [ABSTRACT FROM AUTHOR]

The main contribution of this paper is to develop a method to determine the in situ stress on an engineering scale by modifying the elasto-static thermal stress model (Sheorey’s model). The suggested method, firstly, introduces correction factors for the local tectonism to reflect the stress distribution difference caused by local tectonic movements. The correction factors can be determined by the least-squares approach based on laboratory tests and local in situ stress measurements. Then, the rock elastic modulus is replaced by rock mass elastic modulus so as to show the effect of rock discontinuities on the in situ stress. Combining with elasticity theory, equations for estimating the major and minor horizontal stresses are obtained. It is possible to reach satisfactory accuracy for stress estimation. To show the feasibility of this method, it is applied to two deep tunnels in China to determine the in situ stress. Field tests, including in situ stress measurements by conventional hydraulic fracturing (HF) and rock mass modulus measurements using a rigid borehole jack (RBJ), are carried out. It is shown that the stress field in the two deep tunnels is dominated by horizontal tectonic movements. The major and minor horizontal stresses are estimated, respectively. Finally, the results are compared with those derived from the HF method. The calculated results in the two tunnels roughly coincide with the measured results with an average of 15% allowable discrepancy.