Clinical Analysis of Type II First Branchial Cleft Anomalies in Children

AbstractObjective:We report an interesting case involving a child with a branchial cleft anomaly with two fistulous tracts, one of which was associated with an unusual otoscopic finding.Case report:A seven-year-old girl presented with an apparent type II first branchial cleft cyst after an acute infection. Parotidectomy and excision of the tract were performed, with subsequent development of pre-auricular swelling three months later. Further surgery was performed to remove a second duplication anomaly of the external auditory canal. Otomicroscopy showed a fibrous band arising from the wall of the canal and attached to the tympanic membrane at the umbo.Conclusion:Otoscopic findings on physical examination can be important diagnostic clues in the early recognition of branchial cleft anomalies. The classification system proposed by Work may fail to describe some branchial cleft lesions.

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First Branchial Cleft Anomalies: Rare Work Type I and Type II Entities

Ear Nose & Throat Journal ◽

10.1177/01455613211015737 ◽

2021 ◽

pp. 014556132110157

Author(s):

Konstantinos Tarazis ◽

Konstantinos Garefis ◽

Maria Garefi ◽

Vasilios Nikolaidis ◽

Angelos Chatziavramidis ◽

...

Keyword(s):

Parotid Gland ◽

Type I ◽

Type Ii ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Branchial Anomalies ◽

Work Type

First branchial cleft anomalies (FBCAs) are the most infrequent malformations that occur during the development of the branchial apparatus, appearing in less than 8% of all branchial anomalies. Traditionally, they are classified into Work type I and II, depending on their origin. We present a pair of rare FBCAs: a case of a preauricular Work type I cyst with twin fistulae coursing toward the parotid gland and a Work type II cyst of significant dimensions.

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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

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Collaural fistula (Work Type II first branchial cleft anomaly) with prolonged morbidity: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x211014515 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110145

Author(s):

Dorji Penjor ◽

Morimasa Kitamura

Keyword(s):

External Auditory Canal ◽

Fistulous Tract ◽

Type Ii ◽

Complete Excision ◽

Incision And Drainage ◽

Branchial Cleft ◽

Repeated Infections ◽

Branchial Anomalies ◽

Work Type

Collaural fistula is a very rare Work Type II first branchial cleft anomaly in which there is a complete fistulous tract between external auditory canal and the neck. Misdiagnosis and mismanagement can lead to prolonged morbidity and complications due to repeated infections. We present a case of an 18-year-old lady with a recurrent discharging sinus on her neck for 4 years. She has been treated with repeated incision and drainage and multiple antibiotics in the past. Otoscopic examination revealed an opening on the floor of the left external auditory canal. A diagnosis of an infected collaural fistula was made. Complete excision of the fistulous tract was done after treatment of the active infection. On follow-up, there was no further recurrence at 1 year. Sound knowledge of embryology of branchial anomalies with good history and examination is important to make correct and early diagnosis to prevent morbidity.

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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.

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