Branchio-otic (BO)-syndrome is a relatively uncommon genetic disease, and is characterized by branchial fistulae, congenital preauricular fistulae, and anomalies of the pinnae, external, middle, and inner ears, accompanied by hearing loss. The phenotype varies, so that degree of hearing loss and the type of branchial fistulae vary depending on the patient. Branchial cleft anomaly is common feature of BO syndrome (63%), and most of them are 2nd branchial cleft anomaly. There have been no reports of BO syndrome with 3rd or 4th branchial cleft anomaly published in literature. We report a case of bilateral 3rd branchial cleft anomaly in a 22 year-old male patient with BO syndrome, who treated with chemical and electrocauterization therapy, with a review of literatures.

The recurrent laryngeal nerve (RLN) is an important structure that requires careful attention to be preserved during thyroidectomy. Because injury of this nerve results in vocal cord paralysis, which can lead to voice change, aspiration and even pneumonia. RLN often has branches which is vulnerable to nerve injury during surgery. RLN branch usually occurs close to the cricothyroid joint, or close to the junction between the nerve and the inferior thyroid artery. However, if the RLN branch is located lower than inferior thyroid artery, the risk of nerve damage could be increased. We report this rare anatomic variation of RLN case with a review of the literature.

Hamartomas are malformations resulting in an inappropriate overgrowth of normal adult tissue. They are composed of an abnormal mixture of tissues indigenous to their site of origin. Hamartomas are usually found in the lung, liver, kidney and spleen but are rarely seen in head and neck areas. Symptoms vary according to their location and surgical resection is recommended to relieve the symptoms. We experienced a case of hamartoma in the middle ear which was misconceived as congenital cholesteatoma, and report it with a review of the related literature.

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