scholarly journals Second branchial cleft anomalies: a review of 12 cases

Author(s):  
Niral R. Modi ◽  
Jamin Anadani ◽  
Sanjay M. Tota

<p class="abstract"><strong>Background:</strong> It is a combined retrospective and prospective study of 12 cases of branchial cleft anomalies presented to our hospital. We analysed them for their age and sex incidence, side prevalence, according to clinical features and treatment outcomes.</p><p class="abstract"><strong>Methods:</strong> Thorough history was taken and examination was done and these cases are investigated with CT scan, MRI scan and treated with surgical excision.  </p><p class="abstract"><strong>Results:</strong> Cyst is seen in 7 (58.33%) patients while one case of sinus and one (8.33%) of fistula,1 case of co-existing sinus and fistula (8.33%), and one Bilateral sinus and 1 bilateral fistula (8.33%) were seen. Overall incidences of branchial anomalies are more (40%) in 11-15 year age group. Overall incidence of branchial anomalies is more in male (66.66%) than female (33.33%). 4 cysts were right sided and 3 were left sided. Sinus and fistula were seen one case having right sided and 1 case having bilateral anomaly. Patients having branchial cysts presents most commonly with neck swelling and pain while patients having fistula and sinus presents commonly with discharging opening over anterior neck. 1 case of recurrence found in cyst on follow up and no recurrences were seen in sinus and fistula.</p><p class="abstract"><strong>Conclusions:</strong> Cyst is the most common anomaly, most commonly affected age group is 11-15 years, male are more commonly affected, these anomalies are more prevalent on right side, and there are very less chances of recurrence after surgical excision.</p>

2018 ◽  
Vol 9 (1) ◽  
pp. 2
Author(s):  
M Z Naveed ◽  
A Naveed ◽  
A Irfanullah

Third branchial cleft anomalies are rare accounting for 2-8% of all branchial abnormalities. We report a case of a 9 year old boy who presented with discharging sinus on the left side of neck. A sinogram revealed third branchial arch fistula. The tract was surgically removed, however, on follow up the fistula was recurred. He was later taken for endoscopic cauterization and injection of Histoacryl (n-Butyl cyanoacrylate ) glue into the tract, after which his wound healed swiftly. Historically, surgical excision of the fistulous tract has been the mainstay of treatment. Recently, minimally invasive methods are gaining wider acclaim and may potentially become the treatment of choice in the future.


2009 ◽  
Vol 123 (10) ◽  
pp. 1166-1168 ◽  
Author(s):  
A D Olusesi

AbstractObjective:Branchial cleft anomalies are well described, with the second arch anomaly being the commonest. Following surgical excision, recurrence occurs in 2 to 22 per cent of cases, and is believed to be due largely to incomplete resection. This report aims to describe a simple surgical technique for treatment of second branchial cleft sinus in the older paediatric age group and adults.Methodology:An 11-year-old girl underwent surgical excision of a second branchial sinus. Prior to surgery, she was assessed by means of an imaging sonogram, and by direct methylene blue dye injection into the sinus on the operating table, followed by insertion of a metallic probe. Dissection was of the ‘step ladder’ incision type, but the incision was completed via an oropharyngeal approach. Histological examination of the lesion after excision established the diagnosis. No recurrence had been observed at the time of writing.Conclusions:Although they are congenital lesions, second branchial cleft abnormalities usually present in the older paediatric age group or even in adulthood. In the case reported, a simple combined approach ensured completeness of resection.


2021 ◽  
Vol 9 ◽  
pp. 2050313X2110145
Author(s):  
Dorji Penjor ◽  
Morimasa Kitamura

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.


1992 ◽  
Vol 106 (2) ◽  
pp. 137-143 ◽  
Author(s):  
G. R. Ford ◽  
A. Balakrishnan ◽  
J. N. G. Evans ◽  
C. M. Bailey

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.


Author(s):  
Animesh Agrawal ◽  
Nitish Baisakhiya ◽  
Harshita Sharma

<p class="abstract">Thyroglossal cyst is the most common congenital anterior neck swelling in childhood. Commonly present as painless swelling in the 2nd decade of life but the cases are reported in the elderly age group also. It represents the persistent epithelial tract from the foramen cecum to the thyroid gland. Clinically can be diagnosed and can be differentiated with other mid-line swelling by movement with the protusion of tongue. It is usually related to the hyoid bone and may be supra-hyoid, infra-hyoid, lower part of the midline or rarely lingual in position. Ultrasonography is the investigation of choice for this cystic condition. It is safe, economical and easily available investigation among all the radiological study. MRI is helpful to diagnose cervical extension and lingual cyst. Inspite of close relation to the laryngeal structure it rarely present as laryngeal mass and causes stridor or sleep apnea as in our case. Classic Sistrunk procedure is the treatment of choice for the condition. Endoscopic CO2 Laser is useful in situation where only intraoral cyst present without cervical extension. Marsupialization is reserved for lingual cyst especially in Neonate. We are reporting this case which was present in the elderly and reported with long standing anterior neck swelling with inspiratory stridor on lying down position.</p>


2003 ◽  
Vol 49 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Lina El-Khairy ◽  
Stein E Vollset ◽  
Helga Refsum ◽  
Per M Ueland

Abstract Background: Total cysteine (tCys) in plasma has recently been linked to cardiovascular risk and is also associated with cardiovascular risk factors, including body mass index (BMI) and cholesterol. Changes and predictors of change in tCys concentrations over a mean follow-up time of 6.0 (5.2–7.2) years were assessed in this study. Methods: Baseline data from the Hordaland Homocysteine Study recorded in 1992–1993 included tCys, total homocysteine (tHcy), and various lifestyle and cardiovascular risk factors. In 1998–1999, the same measurements were repeated in 3732 individuals born in 1950–1951 and 3339 individuals born in 1925–1927. Most of the statistical analyses were done separately in the four age and sex groups. Results: The overall mean values of tCys were higher at follow-up [mean (SD), 296 (41) μmol/L] than at baseline [278 (36.5) μmol/L]; P &lt;0.0001. The mean percentage of increase in tCys in the different age and sex groups ranged from 4.9% to 8.5%. There was a significant correlation between the tCys values measured on the two occasions (Spearman correlation coefficient, 0.55–0.59 in the different age and sex groups; P &lt;0.0001). The change in tCys correlated with changes in BMI, cholesterol, and diastolic blood pressure in the younger age group, whereas only changes in BMI predicted changes in tCys in the older age group. Conclusions: tCys increased in the 6 years between the two measurements. Factors related to the baseline tCys values, including BMI and the change in BMI, predicted the tCys changes over time.


2014 ◽  
Vol 3 (3) ◽  
Author(s):  
Tae-Kyung Yoo ◽  
Soo-Hong Kim ◽  
Hyun-Young Kim ◽  
Kwi-Won Park

Branchial cleft anomalies are an important differential diagnosis in congenital neck masses in infants. The third and fourth branchial anomalies are rare branchial cleft anomalies, which are hard to differentiate. We report here an uncommon case of the fourth branchial anomaly that was presented as an asymptomatic neck mass in a neonate.


2018 ◽  
Vol 14 (3) ◽  
pp. 168-171 ◽  
Author(s):  
Apar Pokharel ◽  
TS Rao ◽  
Bikash Pandey ◽  
Chhanya Bhandary ◽  
Prashant Bhatt ◽  
...  

Type 2 branchial cleft anomalies are the most common cause of lateral neck swelling. We report two cases of type 2 branchial cleft anomalies. The first case is branchial cleft cyst and the second one is branchial fistula. Both cases were managed surgically. The post operative outcomes were uneventful. Second branchial cleft anomalies are the most common branchial anomalies. Branchial cysts are more common than sinuses and branchial fistulae are extremely rare. There is no gender predilection. The location, clinical symptoms and imaging findings aid in the diagnosis of this condition. Surgical excision is the mainstay of treatment.Keywords: branchial cleft; branchial cyst; branchial fistula.


FACE ◽  
2022 ◽  
pp. 273250162110722
Author(s):  
Hannes Prescher ◽  
Shelby L. Nathan ◽  
Bruce S. Bauer ◽  
Russell R. Reid

Branchial cleft anomalies are congenital head and neck lesions that arise from incomplete maturation of the branchial apparatus during fetal development. The branchial arches are the precursors of the face, neck and pharynx, and disturbances in embryogenesis can present clinically as cysts, sinus tracts, and fistulas in predictable anatomic locations. However, there remains controversy regarding the precise embryogenesis of branchial cleft anomalies with several competing theories. These lesions often evade diagnosis in early childhood and may present in a delayed fashion after multiple failed interventions. Various diagnostic modalities have been described to facilitate clinical workup. Definitive treatment is complete surgical excision of the lesion. We present a comprehensive review of the literature along with several illustrative cases that highlight the unique challenges of diagnosis and surgical management of branchial cleft anomalies.


2015 ◽  
Vol 105 (5) ◽  
pp. 435-439 ◽  
Author(s):  
Balaji Saibaba ◽  
Pebam Sudesh ◽  
Gokul Govindan ◽  
Mahesh Prakash

Synovial chondromatosis is a rare, usually benign disorder affecting the population predominantly in the third and fourth decades of life and mainly involving the large weightbearing joints of the lower limb—the knees and the hip. In this report, we highlight an unusual pediatric clinical presentation of synovial osteochondromatosis involving the subtalar joint and discuss its surgical management; we also provide a comprehensive up-to-date literature review of the disorder. This patient was successfully treated with en masse surgical excision. He has been doing well, with complete pain relief and improved range of motion at 1-year follow-up. An exceptional involvement of the subtalar joint and an unusual presentation in the pediatric age group makes this case unique.


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