Endoscopic Management of Recurrent Third Branchial Fistula using Histoacryl Glue

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.

Download Full-text

Presentation of Branchial Cleft Anomalies: Case Reports and Review of Literature

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v14i3.21005 ◽

2018 ◽

Vol 14 (3) ◽

pp. 168-171 ◽

Cited By ~ 1

Author(s):

Apar Pokharel ◽

TS Rao ◽

Bikash Pandey ◽

Chhanya Bhandary ◽

Prashant Bhatt ◽

...

Keyword(s):

Clinical Symptoms ◽

Case Reports ◽

Surgical Excision ◽

Operative Outcomes ◽

First Case ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Branchial Fistula ◽

Lateral Neck Swelling

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.

Download Full-text

Second branchial cleft anomalies: a review of 12 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192733 ◽

2019 ◽

Vol 5 (4) ◽

pp. 1075

Author(s):

Niral R. Modi ◽

Jamin Anadani ◽

Sanjay M. Tota

Keyword(s):

Surgical Excision ◽

Age Group ◽

Neck Swelling ◽

Mri Scan ◽

Anterior Neck ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Branchial Anomalies ◽

Age And Sex

Background: 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.Methods: Thorough history was taken and examination was done and these cases are investigated with CT scan, MRI scan and treated with surgical excision. Results: 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.Conclusions: 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.

Download Full-text

Second branchial cleft fistula in a child with genetically confirmed branchio-oto-renal (BOR) syndrome

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0013.1137 ◽

2019 ◽

Vol 8 (1) ◽

pp. 60-66

Author(s):

Agnieszka Remjasz ◽

Pedro Clarós ◽

Andrea Clarós

Keyword(s):

Pediatric Population ◽

Branchial Arch ◽

Renal Anomalies ◽

Fraser Syndrome ◽

Bor Syndrome ◽

Branchial Cleft Anomalies ◽

History Of ◽

Branchial Cleft ◽

Branchial Fistula ◽

Ear Anomalies

Branchial cleft anomalies constitute 32% to 45% of all neck pathologies in the pediatric population. These disorders may be a part of a branchio-oto-renal syndrome (Melnick-Fraser syndrome), characterized by branchial arch abnormalities, preauricular pits, hearing impairment, and various types of renal anomalies. Usually, the treatment of a branchial fistula does not necessarily require extensive diagnostics. However, in patients with a congenital branchial cleft fistula associated with ear anomalies recognized during a physical examination, and history of hearing loss or similar findings in other relatives, the additional analysis should be carried out to eliminate the possibility of BOR syndrome. The aim of this study is to present a rare case of a male patient presenting complete second branchial cleft fistula, diagnosed as having BOR syndrome.

Download Full-text

Three cases of branchial fistula in one family: a rare presentation

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193898 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1425

Author(s):

Rupa Mehta ◽

Jyoti Ranjan Das ◽

Nitin M. Nagarkar

Keyword(s):

Family History ◽

Correct Diagnosis ◽

Surgical Excision ◽

Internal Opening ◽

Rare Presentation ◽

Complete Excision ◽

Complete Surgical Excision ◽

Branchial Cleft Anomalies ◽

Branchial Cleft ◽

Branchial Fistula

Branchial cleft anomalies comprise approximately 30% of congenital neck mass and present as cyst, sinus or fistula. They occur due to disturbance in the maturation of the branchial apparatus during fetal development. They are congenital lesions usually present in childhood, but they are usually diagnosed in later childhood or early adulthood because of enlargement or infection. Branchial cleft fistulae are usually diagnosed earlier than cysts. Correct diagnosis leads to proper management. Complete surgical excision is the treatment of choice. Second branchial cleft and pouch anomalies are commonest amongst all branchial cleft lesions, but complete second branchial cleft anomalies with external and internal opening is rare. Branchial anomalies with family history are also very rare. Here we present a case report of complete branchial fistula with family history which was managed by complete excision of fistula through transcervical and transoral approaches. 3 members of one family in 2 generations presented with branchial apparatus anomalies (father and his two children, elder son and younger daughter). All of them were having branchial fistula on right side of neck since birth.

Download Full-text

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.

Download Full-text

Branchial Cyst in the Parapharyngeal Space: A Case Report

Dubai Medical Journal ◽

10.1159/000514893 ◽

2021 ◽

pp. 1-4

Author(s):

Iyad Said Hamadi ◽

Lubna Lutfi ◽

Asma Anan Mohammed ◽

Zahr Alkhadem

Keyword(s):

Branchial Arch ◽

External Carotid Artery ◽

Cystic Mass ◽

External Carotid ◽

Lateral Side ◽

Branchial Cyst ◽

Embryonic Life ◽

Branchial Cleft ◽

The Right

Branchial cleft cysts are congenital anomalies that most commonly arise from a failure of fusion of the second branchial arch during embryonic life. They usually present as a swelling in the lateral side of the neck, below the mandible. In this article, we present a case of a 28-year-old female patient with a right branchial cyst measuring 7 × 6 × 5 cm, who presented with an asymptomatic, rapidly growing mass in the right anterior triangle of the neck that abutted the right external carotid artery, leading to stenosis of the vessel that is preceded by dilatation above the site of compression. She underwent excision of the cystic mass with preservation of the facial nerve and presented no active complaints on follow-up a few weeks postoperatively.

Download Full-text

A Case of Pyriform Sinus Fistula with Respiratory Distress in the Neonatal Period

Case Reports in Otolaryngology ◽

10.1155/2018/1696875 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Noriko Hamaguchi ◽

Hajime Ishinaga ◽

Kazuki Chiyonobu ◽

Hiroyuki Morishita ◽

Kazuhiko Takeuchi

Keyword(s):

Respiratory Distress ◽

Neonatal Period ◽

Fistulous Tract ◽

Pyriform Sinus ◽

Computed Tomography Imaging ◽

Pharyngeal Wall ◽

Tomography Imaging ◽

Pyriform Sinus Fistula ◽

Branchial Cleft

Pyriform sinus fistula (PSF) is an anomaly that can arise due to failure of involution of the third or fourth branchial cleft during embryogenesis. It can manifest clinically as sinuses, cysts, or abscesses in the neck and is common in childhood. Herein, we describe a neonate who presented with neck swelling and respiratory distress, which was secondary to a fourth branchial pouch sinus. Physical examination revealed swollen areas in the posterolateral pharyngeal wall and on the external left side of the neck. Computed tomography imaging showed a left-sided mass that was filled with air and fluid. Eventually, the pyriform sinus cyst and the entire fistulous tract were excised. The postoperative course was uneventful. Follow-up after 18 months showed no recurrence.

Download Full-text

Branchial Sinus with Cyst - Two Case Reports with Review of Literature

International Journal of Research and Review ◽

10.52403/ijrr.20211147 ◽

2021 ◽

Vol 8 (11) ◽

pp. 375-377

Author(s):

Ashoka Nand Thakur ◽

Priyambada .

Keyword(s):

Histopathological Examination ◽

Case Reports ◽

Branchial Arch ◽

Pharyngeal Arch ◽

Review Of Literature ◽

Complete Excision ◽

Branchial Cyst ◽

Branchial Sinus ◽

Branchial Cleft Anomalies ◽

Branchial Cleft

Branchial cleft anomalies are well described, with the second arch anomaly being the commonest. Remains of cervical sinus of His may persist as a branchial cyst. A branchial sinus is formed when 2nd branchial arch fails to meet the 5th pharyngeal arch. Peak age for presentation of branchial cysts is in the third decade and that of the congenital sinuses and fistulae is at birth. The association of a branchial cyst with branchial sinus is very rare. We are presenting two cases had branchial cyst along with branchial sinus. It was managed successfully with complete excision. Histopathological examination confirmed the association. Keywords: Branchial Sinus, Branchial cyst,

Download Full-text

Computed Tomography Findings of Complete Branchial Cleft Fistula

Ear Nose & Throat Journal ◽

10.1177/0145561320956482 ◽

2020 ◽

pp. 014556132095648

Author(s):

Jackson King ◽

Brian Mitchell

Keyword(s):

Computed Tomography ◽

Rare Variant ◽

Branchial Arch ◽

Neck Mass ◽

Ct Imaging ◽

Lateral Neck ◽

Tonsillar Fossa ◽

Branchial Arches ◽

Branchial Cleft Anomalies ◽

Branchial Cleft

Branchial cleft anomalies are embryonic remnants of the branchial arches and are described as the second most common congenital neck mass. Depending on their extent, these anomalies are classified as a cyst, sinus, or fistula with branchial cysts being the most common. Branchial cysts deriving from the second branchial arch are by far the most common, accounting for approximately 95% of all cases. Complete second branch arch fistulas with both an internal and external opening are a rare variant of this anomaly, and even less have been well-documented on computed tomography (CT) imaging in the literature. We present here a case of a 20-year-old female with CT findings consistent with a complete second branchial arch fistula extending from the tonsillar fossa to the external lateral neck.

Download Full-text

Branchial Cleft Anomalies: Embryogenesis, Clinical Features, Diagnosis, and Management

FACE ◽

10.1177/27325016211072292 ◽

2022 ◽

pp. 273250162110722

Author(s):

Hannes Prescher ◽

Shelby L. Nathan ◽

Bruce S. Bauer ◽

Russell R. Reid

Keyword(s):

Surgical Excision ◽

Definitive Treatment ◽

Review Of The Literature ◽

Complete Surgical Excision ◽

Branchial Arches ◽

Branchial Cleft Anomalies ◽

The Face ◽

Branchial Cleft ◽

Diagnostic Modalities ◽

Anatomic Locations

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.

Download Full-text