scholarly journals First branchial cleft fistula: a case report

2020 ◽  
Vol 6 (8) ◽  
pp. 1568
Author(s):  
Rupa Mehta ◽  
Ankit Mishra ◽  
Nitin M. Nagarkar ◽  
Vandita Singh
Keyword(s):  
Facial Nerve ◽  
External Auditory Canal ◽  
Fistulous Tract ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Lateral Part ◽  
Complete Excision ◽  
Nerve Preservation ◽  
Branchial Cleft

<p class="abstract">First branchial cleft anomalies (BCA) are a rare finding in head and neck with incidence nearly- incidence of nearly 1 million per year which are distributed below external auditory canal, above the hyoid bone, anterior to sternocleidomastoid and posterior to submandibular triangle. First branchial cleft cysts are frequently misdiagnosed as they are rare and pose unfamiliar clinical signs and symptoms. Here we are reporting a case of surgical management of 1st branchial cleft fistula in a 5 years old male child from AIIMS, Raipur, Chhattisgarh, India as it’s a rare entity. Child presented with discharge from right upper part of neck. There was a swelling in right upper lateral part of neck with an opening also in floor of right external auditory canal (EAC). Contrast enhanced computed tomography of neck showed a 4.8 cm long obliquely oriented fistulous tract opening at junction of middle and upper one third of sternocleidomastoid with opening in right EAC. Surgical excision of the fistulous tract was done with preservation of facial nerve. Histopathology examination confirmed the presence of fistula. Common clinical presentation of BCAs is pre-auricular swelling (24%), parotid swelling (36%) or cervical region swelling (41%). In our case, it was a fistulous opening that presented as discharging tract in upper neck. Management include early diagnosis, control of infection and complete excision with facial nerve preservation Surgical approach should be based on the clinical examination, imaging and clinical course; and there is a need to safely identify and preserve facial nerve in almost all cases.</p>

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

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.

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 Unusual case of congenital fistula between external auditory canal and nasopharynx

2021 ◽  
Vol 7 (5) ◽  
pp. 912
Author(s):  
Manit M. Mandal ◽  
Ajay J. Panchal ◽  
Shanu B. Kher ◽  
Harsh G. Dudhani ◽  
Vidhi D. Shah
Keyword(s):  
External Auditory Canal ◽  
Unusual Case ◽  
Fistulous Tract ◽  
External Approach ◽  
Extensive Search ◽  
Neck Area ◽  
Branchial Cleft Anomalies ◽  
Branchial Cleft ◽  
Congenital Fistula

<p class="abstract">Defects in the development in the neck area of the embryo result in branchial cleft anomalies. Various first branchial cleft anomalies are described in literature including preauricular sinuses, cysts and collaural fistula. In our case study, we document a very unusual case of fistula between floor of external auditory canal and nasopharynx. Such patient requires thorough evaluation and step-wise approach to treat. After clinical examination and radiological evaluation, surgically the fistula was excised in toto via external approach using Modified Blair’s incision. In our case, fistulous tract was running from external auditory canal to nasopharynx, running superior and medial to the trunk of facial nerve. No such case is found to be reported in literature after extensive search. Hence, it would be strongly advocated to keep this presentation in the differential diagnosis during evaluation. Also, it is worth mentioning and recommending that a careful radiological examination is a must before approaching for surgery.</p>

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

1994 ◽  
Vol 108 (12) ◽  
pp. 1078-1080 ◽  
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.

scholarly journals Recurrent collaural fistula: a challenge

2019 ◽  
Vol 5 (5) ◽  
pp. 1404
Author(s):  
Shashikant Anil Pol ◽  
Surinder K. Singhal ◽  
Nitin Gupta ◽  
Shalima Pulpra Sivanandan
Keyword(s):  
External Auditory Canal ◽  
Skin Grafting ◽  
Surgical Excision ◽  
Definitive Treatment ◽  
Diagnostic Tools ◽  
Superficial Parotidectomy ◽  
Complete Excision ◽  
Split Skin Grafting ◽  
Branchial Cleft ◽  
Complication Of Surgery

Collaural fistula or cervico-aural fistula is a rare anomaly accounting for less than 8% of first branchial cleft anomaly. Aberrant development of first branchial cleft may lead to formation of a cervical cyst or sinus in the region of ear. We reported a case of a 4 year old girl who presented with recurrent swelling in right infra-auricular region from 6 months of age. She had undergone incision and drainage of the swelling three times at various peripheral hospitals over past 3.5 years. On examination two sinuses were noticed surrounding lobule of right pinna of which one was present posterior to the lobule and second was present just above lobule at lateral most part of conchal cartilage. Diagnosis of recurrent infected collaural fistula requires detailed clinical examination for presence of multiple sinuses surrounding the lobule and external auditory canal. In case of non visibility of sinus in external auditory canal, microscopic examination should be done. CT sonogram and MRI are useful diagnostic tools for recurrent infected fistulas. Surgical excision of whole tract is the definitive treatment but superficial parotidectomy along with it can reduce chances of recurrence significantly. If more than 30% of the circumference of external auditory canal is involved then split skin grafting is required for the coverage. Diagnosis of collaural fistula should be kept in mind whenever there is recurrent postaural or infra-aural swelling mainly in paediatric patients. Superficial parotidectomy along with complete excision reduces the recurrence rate. Facial nerve palsy can be a devastating complication of surgery.

scholarly journals BRANCHIAL CLEFT CYST;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Muhammad Arshad ◽  
Umair Ashafaq ◽  
Mohammad Aslam
Keyword(s):  
Head And Neck ◽  
Surgical Excision ◽  
Lateral Part ◽  
Neck Swelling ◽  
Branchial Cleft Cyst ◽  
Recurrence Rates ◽  
Complete Excision ◽  
Duration Of Symptoms ◽  
Complete Surgical Excision ◽  
Branchial Cleft

Background: Branchial cleft cyst is rare congenital anomaly and most common cause of head and neck pathology in children. Second branchial cyst accounts 95 % of the all brnchial anomalies. It mostly manifest in 2nd and 3rd decade of life. Early diagnosis, controlling the infection status and complete excision without nerve injury is mainstay of treatment. Recurrence rates is very low after complete surgical excision. Study Design: Retrospective study. Setting: Department of Otolaryngology, Head and Neck Surgery, Benazir Bhutto Hospital Rawalpindi. Period: 02 year from August 2016 to July 2018. Methods: 04 cases of branchial anomalies. Age, sex, and duration of symptoms were noted from the case records. The side and site of the lesion and the site of opening of sinuses and fistula were noted. The cystic lesions were investigated with ultrasound and CT scan. Surgical excision of cyst and sinus done. Results: The structure of the studied group was as follows: the ratio men/women was of approximately 3/1; the ratio branchial cysts/branchial sinuses/branchial fistulae = 2/2/0.  Age ranged from 16 to 27 years. Two patients presented with left neck swelling and one patient presented with right neck swelling and one with right sided discharging sinus. Complete surgical excision was done in all cases and no complication occured. Conclusion: Branchial cysts are commonly misdiagnosed and rarely included in the differential diagnosis. Physician should suspect in any patient with a swelling in the lateral part of the neck.

Infection surveillance in nursing homes in Stockholm County, Sweden, 2005 - 2014

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Ann Tammelin
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Urinary Catheter ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
County Council ◽  
Antibiotic Prescribing ◽  
Viral Gastroenteritis ◽  
Stockholm County ◽  
Infection Surveillance

Swedish nursing homes are obliged to have a management system for systematic quality work including self-monitoring of which surveillance of infections is one part. The Department of Infection Control in Stockholm County Council has provided a simple system for infection surveillance to the nursing homes in Stockholm County since 2002. A form is filled in by registered nurses in the nursing homes at each episode of infection among the residents. A bacterial infection is defined by antibiotic prescribing and a viral infection by clinical signs and symptoms. Yearly reports of numbers of infections in each nursing home and calculated normalized figures for incidence, i.e. infections per 100 residents per year, as well as proportion of residents with urinary catheter are delivered to the medically responsible nurses in each municipality by the Department of Infection Control. Number of included residents has varied from 4,531 in 2005 to 8,157 in 2014 with a peak of 10,051 in 2009. The yearly incidences during 2005 - 2014 (cases per 100 residents) were: Urinary tract infection (UTI) 7.9-16.0, Pneumonia 3.7-5.3, Infection of chronic ulcer 3.4–6.8, Other infection in skin or soft tissue 1.4–2.9, Clostridium difficile-infection 0.2–0.7, Influenza 0–0.4 and Viral gastroenteritis 1.2–3.7. About 1 % of the residents have a suprapubic urinary catheter, 6–7 % have an indwelling urinary catheter. Knowledge about the incidence of UTI has contributed to the decrease of this infection both in residents with and without urinary catheter.

Descending Cervical-Sacral Pain after the Administration of Antivenom to the Scorpion Sting Poisoning: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 93-96
Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Case Report ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Scorpion Sting ◽  
Case Presentation ◽  
Sacral Region ◽  
Scorpion Stings

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

scholarly journals Prevalence and Course of IgA and IgG Antibodies against SARS-CoV-2 in Healthcare Workers during the First Wave of the COVID-19 Outbreak in Germany: Interim Results from an Ongoing Observational Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 498
Author(s):  
Mark Reinwald ◽  
Peter Markus Deckert ◽  
Oliver Ritter ◽  
Henrike Andresen ◽  
Andreas G. Schreyer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Significant Proportion ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Observational Cohort Study ◽  
Igg Antibodies ◽  
University Hospitals ◽  
Observational Cohort

(1) Background: Healthcare workers (HCWs) are prone to intensified exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the ongoing pandemic. We prospectively analyzed the prevalence of antibodies against SARS-CoV-2 in HCWs at baseline and follow up with regard to clinical signs and symptoms in two university hospitals in Brandenburg, Germany. (2) Methods: Screening for anti-SARS-CoV-2 IgA and IgG antibodies was offered to HCWs at baseline and follow up two months thereafter in two hospitals of Brandenburg Medical School during the first wave of the COVID-19 pandemic in Germany in an ongoing observational cohort study. Medical history and signs and symptoms were recorded by questionnaires and analyzed. (3) Results: Baseline seroprevalence of anti-SARS-CoV-2 IgA was 11.7% and increased to 15% at follow up, whereas IgG seropositivity was 2.1% at baseline and 2.2% at follow up. The rate of asymptomatic seropositive cases was 39.5%. Symptoms were not associated with general seropositivity for anti-SARS-CoV-2; however, class switch from IgA to IgG was associated with increased symptom burden. (4) Conclusions: The seroprevalence of antibodies against SARS-CoV-2 was low in HCWs but higher compared to population data and increased over time. Screening for antibodies detected a significant proportion of seropositive participants cases without symptoms.

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