Updating concepts of first branchial cleft defects: a literature review

D’Souza, Alwyn; Uppal, Harpreet S.; De, Ranit; Zeitoun, Hisham

doi:10.1016/s0165-5876(01)00612-7

Cited by 149 publications

(128 citation statements)

References 38 publications

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“…Type I lesions present in the parotid region and are ectodermal in origin, and they appear clinically as soft cysts lined by squamous epithelium. Type II lesions present as a cyst, sinus, fistula, or any combination and are of ectodermal and mesodermal origin, containing either skin appendages or cartilage [4,5] . The most common initial symptom of FBCA is swelling in the cervical (41%), parotid (35%), or periauricular regions (24%) with possible external drainage from a skin pit due to recurrent infection or epithelial desquamation [6] .…”

Section: Discussionmentioning

confidence: 99%

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An Effective Surgical Approach for the Management of Recurrent First Branchial Cleft Fistula with Cysts: A Case Report

Jang¹,

Dai²

2017

Int Adv Otol

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Section: Discussionmentioning

confidence: 99%

“…One of the most frequent complications is facial palsy postoperatively. Souza et al [4] found an incidence of this complication ranging from 21% to 41%, including temporary and permanent facial palsy.…”

Section: Introductionmentioning

confidence: 98%

An Effective Surgical Approach for the Management of Recurrent First Branchial Cleft Fistula with Cysts: A Case Report

Jang¹,

Dai²

2017

Int Adv Otol

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“…The tract may pass above or below the facial nerve. 2,12 Third and fourth branchial cleft anomalies appear similar to second branchial cleft anomalies externally with a cutaneous opening in the supraclavicular area; however, internally, they enter the pharynx through the pyriform sinus below the hyoid bone. 2 There were three patients with clavicular sinuses in this study.…”

Section: Discussionmentioning

confidence: 99%

Anomalies of branchial cleft: our experience and review of literature

Shenoy¹,

Tiwari²,

Gandhi³

et al. 2017

Int Surg J

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Background: Anomalies of branchial arches are uncommon anomalies of embryonic development and may present as cysts, sinus tracts, fistulae or cartilaginous remnants. We describe our experience with 30 children with branchial cleft anomalies.Methods: Case records of all patients were retrospectively reviewed and analysed with respect to age, sex, clinical presentation, duration of symptoms, investigations, management and follow up. All patients underwent complete excision of the tract/cyst.Results: There were 15 males and 15 females (ratio of 1:1). The average age of presentation was 5 years. Majority of the patients presented with discharging sinuses (n=26). Twenty-six patients had branchial sinuses, three patients had branchial cysts and one had pyriform fistula. The anomalies were lateralized to left side in 17 patients (56.66%), right side in 11 patients (36.66%) and bilateral in 2 patients (0.066%). Complete excision was done in all patients. Four patients presented with abscesses and required incision and drainage. Definitive surgery was done after 6 weeks. There were no complications.Conclusions: Abnormal development of branchial apparatus lead to formation of different anomalies which remain asymptomatic and present later in life as cysts, sinuses or fistulae in neck. Diagnosis is mostly clinical and complete excision provides definitive cure.

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“…Several variations of type 2 anomalies have been described, including communication with the tympanic cavity and nasopharynx; however, to our knowledge, there is no description of a fistulous tract from the skin going into the EAC directly through a cavity within the styloid process. 2 The styloid bone is widely regarded as a derivative of Reichert cartilage, which is a structure from the second branchial arch that also gives rise to the stapes, the styloid ligament, and the lesser cornu and superior part of the hyoid bone and is therefore not involved in first branchial arch anomalies. An unusual cavity of the styloid process has been described by Prescher et al, 3 who treated an adult patient with a history of chronic otorrhea, multiple otologic procedures, recurring inflammation, and abscesses of the retromandibular and submandibular regions.…”

Section: Workmentioning

confidence: 99%

Persistent Foramen of Huschke Mimicking a Branchial Cleft Anomaly

Silva¹,

Collins²

2012

Arch Otolaryngol Head Neck Surg

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A persistent foramen of Huschke, or foramen tympanicum, results from the defective ossification of the anteroinferior aspect of the tympanic portion of the temporal bone. We describe 2 girls, aged 5 and 6 years, with histories of recurrent cervical abscesses, draining submandibular sinuses, and defective tympanic plates adjacent to the tympanic ring. Surgical resection of the fistulous tract extending from the submandibular triangle to the bony ear canal successfully controlled the symptoms. REPORT OF CASES CASE 1A 5-year-old girl presented to a tertiary care pediatric otolaryngology outpatient clinic with a history of swelling in the anterior aspect of the left side of her neck. She had the sudden onset of left submandibular swelling and erythema 5 weeks before presentation, which then developed into cutaneous drainage and improved after the administration of intravenous antibiotics at a different institution. Her medical history was remarkable for a tympanoplasty and mastoidectomy that had been performed on that same side 1 year earlier, with a diagnosis of chronic suppurative otitis media. On physical examination, she had a draining sinus that was surrounded by granulation tissue right above the hyoid but was afebrile and nontoxic. Computed tomography (CT) revealed a tract extending from the cervical skin up into the bony external auditory canal (EAC) through a dysmorphic anteroinferior wall (Figure 1). The patient was then taken to the operating suite, and the tract was resected through a superficial parotidectomy approach, with facial nerve identification and preservation. The tract extended into the styloid process, which was amputated and packed with a fat plug. Examination of the surgical specimen revealed a 3-cm-long fibrotic tract with acute and chronic inflammation. There were no complications or evidence of recurrence during the 1-year follow-up period. CASE 2A 6-year-old girl presented to the emergency department with the sudden onset of right submandibular swelling, tenderness, and erythema. Associated symptoms also included right-sided otalgia and otorrhea. Her medical history was notable for 2 previous procedures for excision of right submandibular cysts. On physical examination, she had a draining sinus approximately 1 cm below the right angle of the mandible as well as substantial otorrhea and granulation tissue occluding the ear canal. A CT of the neck with contrast showed significant inflammatory changes in the parotid gland, temporomandibular joint, and parapharyngeal space. A superficial parotid fluid collection was drained, and oral and ototopical antibiotic therapy was initiated. After the infection subsided, the results of magnetic resonance imaging confirmed the CT findings of a fistulous tract extending from the submandibular area into the medial aspect of the EAC through a dysmorphic styloid bone and an anteroinferior wall (Figure 2). The patient was also

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Updating concepts of first branchial cleft defects: a literature review

Cited by 149 publications

References 38 publications

An Effective Surgical Approach for the Management of Recurrent First Branchial Cleft Fistula with Cysts: A Case Report

An Effective Surgical Approach for the Management of Recurrent First Branchial Cleft Fistula with Cysts: A Case Report

Anomalies of branchial cleft: our experience and review of literature

Persistent Foramen of Huschke Mimicking a Branchial Cleft Anomaly

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