The relationship between the fistula tract and the facial nerve in type II first branchial cleft anomalies

Branchial cleft anomalies may appear as a sinus fistula or cyst. An understanding of the developmental embryology and anatomy can predict branchial cleft anomalies by the relationship of the corresponding branchial arches that form at the time of development. The second branchial cleft anomalies are the most common and may be found along a tract from the anterior border of the sternocleidomastoid muscle anterior to the carotid vessels and IX and XII. A cyst may form anywhere along this tract but most commonly is just lateral to the internal jugular vein anterior to the carotid vessels. We describe a patient with a second branchial cleft cyst that was posterior to the carotid vessels documented by computed tomography. The cyst was found intraoperatively to be clearly posterior to the common carotid artery. This case demonstrates the need for an understanding of developmental embryology, anatomical landmarks and variations.

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First cleft branchial fistula in a child – a modified surgical technique

The Journal of Laryngology & Otology ◽

10.1017/s0022215100128932 ◽

1994 ◽

Vol 108 (12) ◽

pp. 1078-1080 ◽

Cited By ~ 5

Author(s):

P. Murthy ◽

P. Shenoy ◽

N. A. Khan

Keyword(s):

Surgical Technique ◽

Facial Nerve ◽

Surgical Approach ◽

Surgical Techniques ◽

Type Ii ◽

Complete Excision ◽

Branchial Cleft ◽

Branchial Fistula

AbstractCongenital first branchial cleft fistulae, their embryology, anomalies, varied relationships to the facial nerve and surgical techniques for their excision have been well described in the literature. We report a case of a type II first cleft fistula in a three-year-old child which required a modification of the standard surgical approach to achieve safe and complete excision with identification and preservation of the facial nerve.

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Presentation of first branchial cleft anomalies: the Sheffield experience

The Journal of Laryngology & Otology ◽

10.1017/s0022215106004373 ◽

2006 ◽

Vol 121 (5) ◽

pp. 455-459 ◽

Cited By ~ 22

Author(s):

M Martinez Del Pero ◽

S Majumdar ◽

N Bateman ◽

P D Bull

Keyword(s):

Facial Nerve ◽

External Auditory Meatus ◽

Senior Author ◽

Retrospective Case ◽

Parotid Region ◽

Parotid Surgery ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Incomplete Surgery ◽

Case Note Review

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.

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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.

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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

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First Branchial Cleft Cyst Type II

Journal of Oral & Dental Health ◽

10.33140/jodh/02/02/00005 ◽

2018 ◽

Vol 2 (2) ◽

Keyword(s):

Differential Diagnosis ◽

Facial Nerve ◽

Nerve Injury ◽

Surgical Excision ◽

Type Ii ◽

Neurological Manifestations ◽

Branchial Cleft Cyst ◽

Branchial Cleft ◽

The Right

Branchial cleft defects are interestingly rare and so are often not considered as a differential diagnosis. The following is an incident of the anomalie in a 20 year old Sudanese female with a swelling that was misdiagnosed and hence not treated adequately. The swelling started 2 years ago on the right parotid area with no neurological manifestations of facial nerve injury, with a cystic content that ruptured leaving a fistula behind. After MRI was done the fistula was determined, surgical excision of both the swelling and fistula was done. On follow up, no recurrence was noted.

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An unusual otoscopic finding associated with a type II first branchial cleft anomaly

The Journal of Laryngology & Otology ◽

10.1017/s0022215111003240 ◽

2011 ◽

Vol 126 (3) ◽

pp. 316-318 ◽

Cited By ~ 3

Author(s):

A J Ebelhar ◽

K Potts

Keyword(s):

Case Report ◽

Early Recognition ◽

Acute Infection ◽

Subsequent Development ◽

Interesting Case ◽

Type Ii ◽

Branchial Cleft Cyst ◽

Fibrous Band ◽

Branchial Cleft Anomalies ◽

Branchial Cleft

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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