Anomalies of the branchial arch apparatus in children: case series and review of literature

Abstract

<p>Branchial apparatus develop between the 3rd and 7th weeks of embryonic life. There are five mesodermal arches separated by invaginations of ectoderm and endoderm. Branchial anomalies are result of aberrant embryonic development and are rarely seen in clinical practice. The objective of this article is to present few cases of branchial arch anomalies and to discuss the clinical presentation, diagnosis and surgical approach of such lesions in pediatric age group.</p>

A complete second branchial fistula in a four years old child

“…Second branchial anomalies are the commonest, which cover around 95 % of all branchial anomalies [2] , [3] , [6] . A second branchial anomalies is classified into four subtypes according to Bayley's classification.…”

“…Medial to it there is mesodermal core called arches; those arches will develop into varies structures such as connective tissue, muscles, bones and certain cranial nerves. Lastly, the pouches are the most inner layer of the branchial apparatus, it is covered by endodermal tissue, which will give way to lining epithelium and glands [2] , [3] , [4] .…”

“…If the ectoderm inside the tube did not disappear this will result in branchial cyst. And if the endoderm breakdown and communicate with skin or the mucosa this will results in branchial fistula [3] , [5] .…”

A rare case of second branchial fistula with two external openings

“…And if the endoderm breakdown and communicate with skin or the mucosa this will results in branchial fistula. 3,4 associated with discharge from the openings over the swelling since birth. The swelling was painless, progressively increasing in size.…”