Presentation of first branchial cleft anomalies: the Sheffield experience

Abstract

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.

Analysis of the Clinical Features and Surgical Outcomes of First Branchial Cleft Anomalies

“…In the current study, recurrence was found in seven patients (8.1%, 7/86) and two cases (2.3%, 2/86) with microtia suffered from EAC stenosis after surgery. Scar adhesions from previous infection or surgery as well as from acute inflammation made it difficult to completely remove lesions, causing the recurrence rate to increase to 20% 23,24 . Four out of seven patients who relapsed had a history of drainage or surgery.…”

“…Scar adhesions from previous infection or surgery as well as from acute inflammation made it difficult to completely remove lesions, causing the recurrence rate to increase to 20%. 23,24 Four out of seven patients who relapsed had a history of drainage or surgery. Surgery was not recommended for FBCAs with acute inflammation and the complete dissection of suspicious lesions was performed in patients with a history of inadequate treatment or infection.…”

Unusual presentation of a first branchial arch fistula with maxillofacial infection: a case report

“…However, choosing the optimal surgical time and surgical approach is very important. As reported, recurrence rates were as high as 20% when excision was performed in the acutely inflamed stage [ 24 ]. Repeated infection in the lesion might result in inflammatory adhesion in surrounding tissues and cause structures to be difficult to identify, which may increase the risk of recurrence and injury to the facial nerve.…”