Presentation of first branchial cleft anomalies: the Sheffield experience

2006 ◽  
Vol 121 (5) ◽  
pp. 455-459 ◽  
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.

Rhytidectomy After Parotidectomy

2017 ◽  
Vol 35 (2) ◽  
pp. 92-98
Author(s):  
Boris Paskhover ◽  
Benjamin C. Paul ◽  
David B. Rosenberg
Keyword(s):  
Patient Satisfaction ◽  
Facial Nerve ◽  
Intraoperative Complications ◽  
Case Series ◽  
Surgical Anatomy ◽  
Retrospective Case ◽  
Neck Lift ◽  
Parotid Surgery ◽  
History Of ◽  
Surgical Field

A history of prior parotidectomy is typically thought to substantially increase the risk of facial nerve injury for patients undergoing subsequent facelift surgery. For this reason, surgeons are often hesitant and may even elect not to perform facelift surgery on such patients. However, we have developed a safe and predictable operation for performing the post-parotidectomy rhytidectomy. Here, we present our rationale, approach, and results for performing this operation. This review is a retrospective case series. In total, 1200 facelifts from 2012 to 2016 performed by a single surgeon (D.B.R.) were reviewed. From these, 9 patients were identified as having had parotid surgery prior to rhytidectomy. Rhytidectomy was performed in 8 of 9 cases with a deep-plane, bilaminar approach. There were no intraoperative complications. One patient had a direct neck lift. There were no cases of revision. There were no cases of facial nerve damage including paresis or paralysis; 100% patient satisfaction was noted. Rhytidectomy with a deep-plane approach may be performed safely in patients who have undergone prior parotidectomy. Although there were no complications, revisions, postoperative asymmetry, or dissatisfaction in the patients in this study, it must be stressed that there is no substitute for a thorough appreciation of the surgical anatomy in combination with consideration of the changes to the surgical field that occur with parotid surgery.

Parotidectomy in children: indications and complications

2010 ◽  
Vol 124 (12) ◽  
pp. 1289-1293 ◽  
Author(s):  
C Meiling Xie ◽  
H Kubba
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Mycobacterial Infection ◽  
Paediatric Hospital ◽  
Gustatory Sweating ◽  
Atypical Mycobacterial Infection ◽  
Parotid Surgery ◽  
Branchial Cleft ◽  
Indications And Complications

AbstractBackground:Parotidectomy in children is uncommon, and surgeons face specific challenges not encountered in adult practice.Method:Retrospective review of parotidectomies performed in our paediatric hospital over a 10-year period (1999–2008).Results:Twenty-one children underwent 22 parotidectomies, of which six were total. The following pathology was encountered: atypical mycobacterial infection (8.38 per cent), pleomorphic adenoma (4.19 per cent), lymphatic malformation (2.10 per cent), haemangioma (2 per cent), first branchial cleft anomaly (2 per cent), follicular non-Hodgkin's lymphoma (2 per cent) and lipoblastoma (1.5 per cent). No cases of permanent facial nerve palsy occurred. Mild transient facial nerve palsy occurred in five patients (23 per cent), gustatory sweating in four (19 per cent) and hypertrophic scarring in three (14 per cent).Conclusion:We discuss the range of parotid pathology found in children, the approach to investigation, the surgical difficulties encountered, and ways to reduce the apparently higher rate of complications encountered. Parotid surgery in children should be concentrated in the hands of a small number of surgeons with a particular interest in this area.

First Branchial Cleft Anomalies and the Facial Nerve

1983 ◽  
Vol 91 (2) ◽  
pp. 197-202 ◽  
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.

scholarly journals Variable relationship of retro-mandibular vein to the facial nerve, a finding during parotid surgery: a rare case report

2017 ◽  
Vol 4 (9) ◽  
pp. 3166
Author(s):  
V. Jayapala Reddy ◽  
T. Hemachandra ◽  
S. Nagesh Kumar ◽  
P. V. Ramasubba Reddy
Keyword(s):  
Facial Nerve ◽  
Anatomical Variations ◽  
Needle Aspiration ◽  
Classical Text ◽  
Parotid Region ◽  
First Case ◽  
Parotid Surgery ◽  
Rare Case Report ◽  
History Of ◽  
Needle Aspiration Cytology

Studies describing the anatomical relation and variability of facial nerve and retro-mandibular vein were mostly on cadavers. Intraoperative encounter of variable anatomy in parotid surgery is rarely reported in literature. The usual location of retro-mandibular vein is medial to facial nerve as described in many classical text books is around 88%. Here we present a case with variable anatomy of retromandibular vein. A 55-year-old Indian gentleman presented with history of painless swelling in left parotid region for 5 months. On clinical examination, a 3×3 cm swelling probably arising from left parotid gland was felt. Preoperative ultrasonography described it as parotid cyst arising from inferior pole. Fine needle aspiration cytology described it as benign parotid cyst. A superficial parotidectomy was planned and executed. During surgery, the retro-mandibular vein was found crossing the two trunks of the facial nerve laterally (superficial to facial nerve) in between the division of facial nerve trunk and origin of ramifications. Usually retro-mandibular vein runs medial (deep) to the facial nerve trunks. Anatomical variations between facial nerve and retro-mandibular vein are underreported and not given due importance during training. With this article, we want to emphasize the importance of having awareness regarding anatomical variations related to facial nerve and retro-mandibular vein and be prepared to encounter during surgery there by preventing complications. We are reporting the first case from India.

First branchial cleft anomaly extending to parapharyngeal space

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.

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