Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series

Autor: Lourdes Quintanilla-Dieck, Frank Virgin, Chistopher Wootten, Steven Goudy, Edward Penn
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Case Reports in Otolaryngology, Vol 2016 (2016)
Druh dokumentu: article
ISSN: 2090-6765
2090-6773
DOI: 10.1155/2016/3902974
Popis: Objectives. First branchial cleft anomalies (BCAs) constitute a rare entity with variable clinical presentations and anatomic findings. Given the high rate of recurrence with incomplete excision, identification of the entire tract during surgical treatment is of paramount importance. The objectives of this paper were to present five anatomic variations of first BCAs and describe the presentation, evaluation, and surgical approach to each one. Methods. A retrospective case review and literature review were performed. We describe patient characteristics, presentation, evaluation, and surgical approach of five patients with first BCAs. Results. Age at definitive surgical treatment ranged from 8 months to 7 years. Various clinical presentations were encountered, some of which were atypical for first BCAs. All had preoperative imaging demonstrating the tract. Four surgical approaches required a superficial parotidectomy with identification of the facial nerve, one of which revealed an aberrant facial nerve. In one case the tract was found to travel into the angle of the mandible, terminating as a mandibular cyst. This required en bloc excision that included the lateral cortex of the mandible. Conclusions. First BCAs have variable presentations. Complete surgical excision can be challenging. Therefore, careful preoperative planning and the recognition of atypical variants during surgery are essential.
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