Anatomical Variations of the Facial Nerve in First Branchial Cleft Anomalies

Abnormalities of the first branchial cleft are rare. They may present with a cutaneous defect in the neck, parotid region, external auditory meatus or peri-auricular area, or with inflammatory or infective lesions at these sites.A retrospective case note review of the patients treated by the senior author is presented. This group consisted of 18 patients and represents the largest published UK series to date. Eleven patients (65 per cent) had undergone incomplete surgery prior to referral.Over half the patients had a clinically apparent lesion in relation to the external auditory meatus. There was a variable relationship between the tract and the facial nerve, which was identified at surgery in 15 cases.These findings are consistent with those of previously published series. Clinicians should keep this diagnosis in mind when assessing patients with infected lesions in the neck and parotid area. Surgeons should be familiar with parotid surgery, in children where appropriate, and be prepared to expose the facial nerve before embarking on the surgical management of these lesions.

Download Full-text

First Branchial Cleft Anomalies and the Facial Nerve

Otolaryngology ◽

10.1177/019459988309100216 ◽

1983 ◽

Vol 91 (2) ◽

pp. 197-202 ◽

Cited By ~ 16

Author(s):

Robert G. McRae ◽

K.J. Lee ◽

Eugene Goertzen

Keyword(s):

Facial Nerve ◽

Surgical Management ◽

Fistulous Tract ◽

Age Groups ◽

Clinical Problem ◽

Cystic Lesions ◽

Nerve Preservation ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Branchial Anomalies

First branchial cleft anomaly is an uncommon clinical problem that can be difficult to diagnose and treacherous to treat. It is generally believed that branchial anomalies arise from incomplete resolution of branchial cleft remnants. They may be a fistulous tract or cystic lesions, and they may be found in all age groups. This article presents three cases of first branchial cleft anomaly and offers an overview of the regional embryology and guidelines for surgical management and facial nerve preservation.

Download Full-text

THE RELATIONSHIP OF THE FACIAL NERVE AND FIRST BRANCHIAL CLEFT ANOMALIES ??? EMBRYOLOGIC CONSIDERATIONS

The Laryngoscope ◽

10.1288/00005537-198211000-00017 ◽

1982 ◽

Vol 92 (11) ◽

pp. 1308???1310 ◽

Cited By ~ 5

Author(s):

Stephen L. Liston

Keyword(s):

Facial Nerve ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Relationship Of ◽

The Relationship

Download Full-text

Two Cases of First Branchial Cleft Anomalies Medial to the Facial Nerve

Journal of Current Surgery ◽

10.4021/jcs9w ◽

2012 ◽

Author(s):

Choi

Keyword(s):

Facial Nerve ◽

Branchial Cleft Anomalies ◽

Branchial Cleft

Download Full-text

First branchial cleft anomaly extending to parapharyngeal space

BMJ Case Reports ◽

10.1136/bcr-2021-244842 ◽

2021 ◽

Vol 14 (8) ◽

pp. e244842

Author(s):

K Devaraja ◽

Vishwapriya Mahadev Godkhindi ◽

Ajay M Bhandarkar

Keyword(s):

Facial Nerve ◽

Parapharyngeal Space ◽

Present Report ◽

Open Approach ◽

Resonance Imaging ◽

Superficial Parotidectomy ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Peculiar Case ◽

Extensive Surgery

First branchial cleft anomalies are quite rare, and the majority of them are found in and around the ear canal, mostly superficial to the facial nerve. Very rarely, the anomalous tract of the first branchial cleft can go deeper to the facial nerve, necessitating a meticulous and extensive surgery. A 21-year-old student presented with slowly increasing cystic swelling in the infra-auricular region. Findings of the magnetic resonance imaging were consistent with the first branchial cleft cyst, which also exhibited a deeper extent of the lesion into the parapharyngeal space. The entire tract was excised along with the superficial parotidectomy by an open approach. In addition to illustrating the presentation and management of this peculiar case, the present report also reviews the latest literature around their management.

Download Full-text

Intraoperative use of fibrin glue dyed with methylene blue in surgery for branchial cleft anomalies

The Laryngoscope ◽

10.1002/lary.25833 ◽

2016 ◽

Vol 126 (9) ◽

pp. 2147-2150 ◽

Cited By ~ 12

Author(s):

Michela Piccioni ◽

Marco Bottazzoli ◽

Nader Nassif ◽

Stefania Stefini ◽

Piero Nicolai

Keyword(s):

Methylene Blue ◽

Fibrin Glue ◽

Branchial Cleft Anomalies ◽

Branchial Cleft

Download Full-text

Branchial cleft and pouch anomalies

The Journal of Laryngology & Otology ◽

10.1017/s0022215100118900 ◽

1992 ◽

Vol 106 (2) ◽

pp. 137-143 ◽

Cited By ~ 136

Author(s):

G. R. Ford ◽

A. Balakrishnan ◽

J. N. G. Evans ◽

C. M. Bailey

Keyword(s):

Recurrent Infection ◽

Theoretical Description ◽

The Other ◽

Unexpected Finding ◽

Neck Swelling ◽

Complete Excision ◽

Delay In Diagnosis ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Sick Children

AbstractWe present a retrospective study of 106 patients with branchial cleft and pouch anomalies who presented to the Hospital for Sick Children between 1948 and 1990. The relevant embryology of the branchial apparatus is summarized and a theoretical description of individual anomalies given.Second branchial cleft sinuses were the most common anomalies, and the majority were managed simply, with adequate excision and a low recurrence rate. Five cases of first branchial cleft anomalies are presented, emphasizing the delay in diagnosis, the need for complete excision to prevent recurrence, and for a parotidectomy incision to protect the facial nerve from damage. The two third branchial pouch anomalies presented with a cystic neck swelling, one with recurrent infection and discharge, and the other with stridor. In both, the diagnosis was made at operation. The single fourth branchial pouch cyst was an unexpected finding in a patient with stridor.

Download Full-text