Branchial Cleft Fistula Research Articles

First branchial cleft fistula: A case report

First branchial cleft anomalies are a rare group of congenital malformations, accounting for about 5% of branchial cleft defects. The diagnosis may not be clear since their presentation is similar to other clinical conditions such as lymphadenitis, dermoid cyst, cystic hygroma, lymphangioma, primary parotid tumor, etc. Surgical excision requires a wide exposure so as not to damage the facial nerve. We report a case of a 2-year-old boy with a first branchial cleft fistula, in which a seropurulent discharge was observed through the cleft and along the ear canal.

Bilateral First and Second Branchial Cleft Fistulas: A Case Report

Branchial cleft anomalies--which include branchial cysts, sinuses, and fistulas--are uncommon developmental defects of the neck. Approximately 2 to 3% of cases are bilateral; bilateral presentations appear to have a familial component. Only 5 cases of bilateral branchial cleft fistulas have been reported in the English-language literature, and only 1 case of simultaneous first and second branchial cleft fistulas has been previously reported. We report what to the best of our knowledge is the second case of bilateral first and second branchial cleft fistulas.

Fourth branchial cleft sinus: relationship to superior and recurrent laryngeal nerves

Objectives 1) Demonstrate the surgical anatomy of a fourth branchial cleft sinus relative to the superior and recurrent laryngeal nerves. 2) Review the diagnosis and management of a fourth branchial cleft sinus. Design Case Study. Setting Tertiary Children’s Hospital. Patient Three year old female who presented with a fever and painful right neck mass. CT scan demonstrated a right neck abscess containing air adjacent to the thyroid. Intervention Two months after initial drainage, the patient underwent enbloc excision of the sinus including the thyroid lobe with closure of the piriform sinus defect. Main outcome measure Intraoperative photo documentation of the anatomic relationship between the fourth branchial sinus and surrounding neural structures. Results The sinus tract was shown to terminate in the piriform sinus inferior to the superior laryngeal nerve.

Third branchial cleft fistula infected with Actinomyces

Third branchial cleft fistula infected with Actinomyces

Third branchial cleft fistula infected with Actinomyces

Third branchial cleft fistula infected with Actinomyces

Third branchial cleft fistula infected with Actinomyces

A 16-year-old male with a 10-year history of recurrent left lateral neck swelling and an associated draining fistula was taken to surgery for excision of the fistula. Histologic examination of the surgical specimen demonstrated findings consistent with Actinomyces species. We suspect that this patient had a third branchial cleft fistula that was infected with Actinomyces .

P-294B A report on two cases of children with the first branchial cleft fistula(Chest and abdominal wall, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-294B A report on two cases of children with the first branchial cleft fistula(Chest and abdominal wall, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

First branchial cleft fistula presenting with external opening on earlobe

First branchial cleft fistula is a rare congenital malformation of the head and neck with an incidence of less than 10% of all branchial cleft defects. We herein report a 15-year-old girl who had a cystic mass in the postauricular region with an external opening on the posterior face of the earlobe. Surgical exploration revealed that a second sinus tract was passing through the conchal cartilage without going beyond the skin of the external acoustic meatus. The mass and the tract were excised along with the opening on the earlobe as well as the skin island surrounding the opening. The case was treated surgically with success . The significance of our case was the location of external opening on the earlobe.

Congenital Sialo-Cutaneous Fistula of the Parotid Salivary Gland: A First Branchial Cleft Anomaly: A Case Report

Anomalies in the development of the branchial apparatus may result in the formation of cysts, sinuses and fistulas in the head and neck region. These anomalies are rare and when they do occur, the first branchial cleft fistulas are even rarer with less than 50 cases reported worldwide. A case of first branchial cleft anomaly presenting as a congenital sialo-cutaneous fistula is hereby reported.. Keywords : branchial, cleft, sialo-cutaneous, fistula. African Journal of Paediatric Surgery Vol. 3 (1) 2006: pp. 45-47

Hereditary ectopic salivary gland: Survey of three generations

An ectopic salivary gland is different from a branchial cleft fistula, which generally results from heteroplasia within the remnants of the second branchial cleft. Compared to a branchial cleft fistula, surgery for an ectopic salivary gland is relatively simple. This study describes five generations of a family with typical clinical features of ectopic salivary gland in the neck. This study is the first to report the rare familial occurrence of ectopic cervical salivary gland and discuss its imaging results, surgical management, and histopathology.

Second branchial cleft fistula: Is fistulogram necessary for complete excision

We present our 10 years experience (1995-2005) of second branchial cleft fistulas and sinuses in the pediatric age group by retrospective analysis of records of 52 patients (with 63 fistulas) whose sinuses or fistulas were excised. It was found to be thrice as common in males as compared to females and was predominantly unilateral. The role of fistulogram and methylene blue dye injection in delineation and complete surgical excision of the tract was evaluated. Twenty-five cases were managed by pre-operative fistulogram and intra-operative dye injections for excision, whereas 38 cases of branchial fistulas and sinuses were excised without fistulogram and dye injection. Fistulogram and dye injection were found to be of no extra help during excision of the tract. There were two recurrences.

Heterotopic Salivary Gland Tissue: A Case Report Demonstrating Evolution and Association with the Branchial Apparatus

Heterotopic salivary gland tissue (HSGT) in the lower neck is an unusual developmental anomaly with characteristic clinical and microscopic findings. The exact embryogenesis remains unclear. This rare entity must be considered in the differential diagnosis of neck mass with fistula. We present a typical HSGT totally removed using the stepladder excision technique and showing an internal fistula. Interpretation of this case from the anatomical and pathological points of view, we support the argument that the embryogenesis of HSGT is more probably related to ectodermal heteroplasia of the precervical sinus of His and further conclude that an association with branchial cleft sinus may exist and cannot be seen as an exclusion criteria for diagnosis of HSGT. Due to possible but infrequent neoplastic transformation, it is important to check HSGT in every encountered cervical anomaly related to any branchial apparatus derived lesion.

New ophthalmic manifestations of branchio-oculo-facial syndrome

To report new ocular manifestations of branchio-oculo-facial (BOF) syndrome. Case report. A 10-year-old girl with known BOF syndrome was referred because of a fundus lesion in her left eye. She had undergone excision of a left orbital dermoid cyst at age 18 months and a branchial cleft fistula from the right side of neck at age 4 years. Examination disclosed openings of sinus tracts on each side of the nose connecting the lacrimal sac to skin. In the right eye, an iris pigment epithelial cyst was confirmed with ultrasound biomicroscopy. In the left eye, there was a combined hamartoma of the retina and retina pigment epithelium. BOF syndrome can display mild to severe craniofacial, auricular, oral, and ophthalmic anomalies. In this case, the ophthalmic manifestations included lacrimal sac fistula, orbital dermoid cyst, iris pigment epithelial cyst, and combined hamartoma of the retina and retinal pigment epithelium.

Second branchial cleft sinus presenting after adenotonsillectomy

Branchial cleft sinuses are one of the more common congenital defects arising in the head and neck region. Second branchial cleft anomalies are the commonest of the true branchial cleft defects and the diagnosis is usually straightforward. We report the case of an atypical presentation of branchial cleft sinus that manifested after adenotonsillectomy. To our knowledge this is the first reported case of a second branchial cleft sinus presenting only after adenotonsillectomy. The sinus was excised with no recurrence of symptoms at 12 months of follow-up.

Unusual association of congenital middle ear cholesteatoma and first branchial cleft anomaly: management and embryological concepts

To report two cases of an undescribed association of first branchial cleft fistula and middle ear congenital cholesteatoma and to discuss management and embryological hypothesis. Retrospective study and review of the literature Both patients were young girls free of past medical or surgical history. Surgical removal of the first cleft anomaly found in the two cases a fistula routing underneath the facial nerve. Both cholesteatomas were located in the hypotympanum, mesotympanum. In one case, an anatomical link between the two malformations was clearly identified with CT scan. The main embryological theories and classification are reviewed. A connection between Aimi's and Michaels' theories (congenital cholesteatoma) and Work classification might explain the reported clinical association.

Endoscopic cauterization of fourth branchial cleft sinus tracts.

To evaluate the effectiveness of endoscopic cauterization as definitive treatment for fourth branchial cleft sinuses. Retrospective chart review with follow-up questionnaire. Tertiary care children's hospital. Ten children (age range, 10 months to 10 years) with fourth branchial cleft sinuses treated with endoscopic cauterization between 1995 and 2002. Recurrence of neck infections after endoscopic cauterization of fourth brachial cleft sinus tracts. Seven of the 10 patients treated with endoscopic cauterization of the fourth branchial cleft sinuses showed no recurrence with an average follow-up of 3 years. Three of the patients were unavailable for follow-up, but medical records of the hospital showed no additional admissions for those patients for neck masses. No morbidity of the procedure was identified. All patients were discharged the day of surgery. Endoscopic cauterization of fourth branchial cleft sinuses appears to be an effective alternative to open excision.

Simultaneous Carotid Endarterectomy and Excision of Ipsilateral Branchial Cleft Fistula

Branchial cleft sinuses are congenital anomalies that usually present in childhood or early adulthood. It is uncommon that such a sinus will remain asymptomatic to the sixth decade of life. This case describes the presence of a second branchial cleft sinus in the setting of carotid artery disease, where both were treated surgically simultaneously without complication.

A myringeal web associated with first branchial cleft sinus

A myringeal web associated with first branchial cleft sinus

Branchial cleft fistulae

Three rare and interesting cases of complete branchial cleft fistulae including two cases with unusual presentation are reported. Total excision of the fistulae was carried out by step ladder technique in all the three cases resulting in their successful surgical management. Relevant available literature on the subject has been reviewed.

Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients

A retrospective analysis of 183 patients undergoing surgical treatment for branchial cleft cysts and fistulae between 1970 and 1990 was carried out. There were 148 (80.8%) cases of branchial cleft cysts and 35 (19.2%) cases of branchial cleft fistulae. In patients with branchial cysts, the most frequent clinical presentation consisted of a left-sided, painless, cervical mass. Patients with a branchial fistula presented with persistent mucous discharge from a skin opening in the neck. The introduction of ultrasonography, computed tomography, and magnetic nuclear resonance imaging has improved the accuracy of traditional radiologic methods such as parotid sialography and fistulography. Complete excision under general anesthesia is the treatment of choice, and the procedure is associated with a low incidence of local complications and neurologic sequelae. The overall recurrence rate was 4.9% after a follow-up of 2 years.