Branchial Cleft Anomalies in Children

Abstract

INTRODUCTION: Objective: A retrospective study was planned to evaluate the clinical and radiological findings of childhood branchial anomalies together with the subclasses of the anomaly and to discuss the surgical results. Method: The medical records of the patients managed for branchial cleft anomaly between 2014 and 2019 were examined. Demographic features, clinical and radiological findings, surgical managements and outcomes were recorded. Results: Eighteen cases were included in the study. Median age of the cases was 5 years (1-14). Male/female ratio was 9/9. The complaints were discharge from the BC (n=13, 72%) and painless neck mass (n=3, 17%). The BC was at right side in 8 (44%), left side in 9 (%50) and bilateral in 1 case (6%). Physical examination revealed the presence of a fistula, and its orifice in 14 cases and cystic lesion was palpable in 4 cases. Ultrasound was performed in 9 cases (50%) and cyst could be detected in 3 of them. All cases were operated and step-ladder incision was used in 8 cases. The fistula tract was ended near to pharynx in 2, near to pretonsillar fossa in 10, submandibular region in 5, and external auditory tract in 1 case. Histopathological examination revealed inflammation in 2 cases and cartilage in 1 case. Stratified ciliary columnar and stratified squamous cell epithelium was detected in samples. Conclusion: Physical examination is the most important diagnostic method. The management is surgery and excision of whole lesion is important in preventing recurrences. Although using methylene blue is a guiding technique in surgical excision of tracts, the effect of its use on surgical outcome and recurrence rates is still debatable.