DOI: https://dx.doi.org/10.18203/2349-2902.isj20174108
Published: 2017-09-27

Anomalies of branchial cleft: our experience and review of literature

Neha Sisodiya Shenoy, Charu Tiwari, Suraj Gandhi, Pankaj Dwivedi, Hemanshi Shah

Abstract


Background: Anomalies of branchial arches are uncommon anomalies of embryonic development and may present as cysts, sinus tracts, fistulae or cartilaginous remnants. We describe our experience with 30 children with branchial cleft anomalies.

Methods: Case records of all patients were retrospectively reviewed and analysed with respect to age, sex, clinical presentation, duration of symptoms, investigations, management and follow up. All patients underwent complete excision of the tract/cyst.

Results: There were 15 males and 15 females (ratio of 1:1). The average age of presentation was 5 years. Majority of the patients presented with discharging sinuses (n=26). Twenty-six patients had branchial sinuses, three patients had branchial cysts and one had pyriform fistula. The anomalies were lateralized to left side in 17 patients (56.66%), right side in 11 patients (36.66%) and bilateral in 2 patients (0.066%). Complete excision was done in all patients. Four patients presented with abscesses and required incision and drainage. Definitive surgery was done after 6 weeks. There were no complications.

Conclusions: Abnormal development of branchial apparatus lead to formation of different anomalies which remain asymptomatic and present later in life as cysts, sinuses or fistulae in neck. Diagnosis is mostly clinical and complete excision provides definitive cure.


Keywords


Branchial apparatus, Cyst, Fistula, Sinus

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References


Prasad SC, Azeez A, Thada ND, Rao P, Bacciu A, Prasad KC. Branchial anomalies: Diagnosis and management. Int J Otolaryngol. 2014;2014:237015.

Adams A, Mankad K, offiah C, Childs L. Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings. Insights Imaging. 2016;7:69-76.

Schoenwolf G, Bleyl S, Brauer P, Francis-West P. Larsen’s Human Embryology, 4th edn. Churchill Livingston, New York, Edinburgh; 2019.

Waldhausen J. Branchial cleft and arch anomalies in chil- dren. Semin Pediatr Surg. 2006;15:64-9.

Koeller K, Alamo L, Adair C, Smirniotopoulos J. Congenital cystic masses of the neck: radiologic-pathologic correlation. Radiographics. 1999;19(1):121-46.

Choi SS, Zalzal GH. Branchial anomalies: a review of 52 cases. Laryngoscope. 1995;105(9)909-13.

Harnsberger H, Mancuso A, Muraki A, Byrd S, Dillon W, Johnson L, et al. Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiol. 1984;152(3):739-48.

Ford GR, Balakrishnan A, Evans JNG, Bailey CM. Branchial cle and pouch anomalies. J Laryngol Otol. 1992;106(2):137-53.

Bajaj Y, Ifeacho S, Tweedie D. Branchial anomalies in children. Int J Pediatr Otorhinol. 2011;75(8):1020-3.

Clevens R, Weimert T. Familial bilateral branchial cleft cysts. Ear Nose Throat J. 1995;74(6):419-21.

Bajaj Y. Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 2011;75:1020-3.

D’Souza A, Uppal H, De R, Zeitoun H. Updating concepts of first branchial cleft defects: a literature review. Int J Pediatr Otorhinolaryngol. 2002;62:103-9.

Harnsberger R. Diagnostic imaging: head and neck, 2nd edn. Amirsys, Lippincott; 2011.

Ewing CA, Kornblut A, Greeley C, Manz H. Presentation of thyroglossal duct cysts in adults. Eur Arch Otorhinolaryngol. 1999;256:136-8.

D. Reiter. ird branchial cle sinus: an unusual cause of neck abscess. Int J Pediatr Otorhinolaryngol. 1982;4(2):181-6.

Ahuja A, King A, Metreweli C. Second branchial cleft cysts: variability of sonographic appearances in adult cases. AJNR Am J Neuroradiol. 2000;21:315-9

Bajaj Y, Tweedie D, Ifeacho S, Hewitt R, Hartley B. Surgical technique for excision of first branchial cleft anomalies: how we do it. Clin Otolaryngol. 2011;36:371-92.