Second Branchial Anomalies: A Study of 94 Cases

Abstract

Ninety-four patients with second branchial anomalies were retrospectively analysed at a tertiary care centre from January 2006 to September 2016 to determine the demographical data and management. Branchial sinus and fistula presented earlier as compared to branchial cyst. The mean age at presentation in case of branchial sinuses, fistulae and cysts was 5.07, 5.79 and 7.31 years respectively. There was preponderance in males as compared to females, more so in bilateral cases. Male to female sex ratio was 2.91:1. The branchial fistulae were the most common type of lesions, followed by the branchial sinuses. The branchial anomalies were more on the right side (65.96%) probably due to right handedness of the population. Only eight patients (8.51%) had bilateral anomalies. Four patients had familial association, it was seen in bilateral cases and they presented earlier than unilateral cases. Early and complete surgical excision is the treatment of choice. Preoperative sinogram/fistulogram and intraoperative methylene blue dye injection is not mandatory for excision of a branchial sinus/fistula. Post-operative wound infection was the most common complication (4.25%).

Unusual Isolated Parapharyngeal Second Branchial Cleft Cyst: A Case Report and Literature Review

“…Pediatric presentations are exceptional [ 16 , 24 , 27 ]. Symptoms are frequently insignificant and related to mass size with main presentation being sense of throat lump eventually leading to dysphagia or odynophagia without an external neck swelling [ 18 , 20 , 25 , 32 ]. Unusually, Saussez et al [ 29 ] reported a case with one-year history of snoring and no dysphagia.…”

Complete second arch branchial fistula in a 3-yearold child

“…In case of unilateral, the right side preponderance is described. 5 Fistulography and computed tomography (CT) fistulogram are the modality of choice for radiological diagnosis of second branchial arch fistula (Figure 1). 1,3,5 Fistulography (performed with opacifying the fistula with contrast media) delineates the fistulous tract extending from the external cutaneous opening at the lateral neck to the tonsillar fossa.…”

“…5 Fistulography and computed tomography (CT) fistulogram are the modality of choice for radiological diagnosis of second branchial arch fistula (Figure 1). 1,3,5 Fistulography (performed with opacifying the fistula with contrast media) delineates the fistulous tract extending from the external cutaneous opening at the lateral neck to the tonsillar fossa. 1,2 CT fistulogram with reformatted images demonstrates the fistulous tract as well as its relationship with important structures of the neck.…”

“…1 Ultrasound and magnetic resonance imaging (MRI) has less diagnostic value in the diagnosis of fistulous tract, but more advantageous in the diagnosis of branchial arch cysts. 1,5 Second arch branchial fistula are usually diagnosed in infancy or childhood with patient presenting with the complaints of watery or purulent discharge from an opening at the anterior aspect of lower third of the neck. 3 The treatment of choice of second branchial arch fistula is complete surgical excision of the fistulous tract.…”

A Systematic Literature Review to Compare Clinical Outcomes of Different Surgical Techniques for Second Branchial Cyst Removal

“…Traditionally, conventional surgery using a large cervical incision was used to ensure complete removal. 10-31 However, the large cervical incision results in a prominent scar. In an attempt to reduce visible scars, newer techniques have been developed, such as endoscopic surgery 9,32-35 and the use of a retro-auricular hairline incision (RAHI).…”