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Current management of congenital branchial cleft cysts, sinuses, and fistulae.
Curr Opin Otolaryngol Head Neck Surg. 2012 Dec; 20(6):533-9.CO

Abstract

PURPOSE OF REVIEW

Branchial anomalies comprise approximately 20% of pediatric congenital head and neck lesions. This study reviews current literature detailing the diagnosis and management of first, second, third and fourth branchial cysts, sinuses and fistulae.

RECENT FINDINGS

Branchial anomalies remain classified as first, second, third and fourth cysts, sinuses and fistulae. Management varies on the basis of classification. The imaging study of choice remains controversial. Computed tomography fistulography likely best demonstrates the complete course of the tract if a cutaneous opening is present. Treatment of all lesions has historically been by complete surgical excision of the entire tract. Studies of less invasive procedures for several anomalies are promising including sclerotherapy and endoscopic excision of second branchial cysts, and endoscopic cauterization or sclerotherapy at the piriform opening for third and fourth branchial sinuses. An increased risk of complications in children less than 8 years is reported in children undergoing open excision of third and fourth branchial anomalies.

SUMMARY

Branchial anomalies are common congenital pediatric head and neck lesions but are comprised by several diverse anomalies. Treatment must be tailored depending on which branchial arch is involved and whether a cyst mass or sinus/fistula tract is present.

Authors+Show Affiliations

Department of Otorhinolaryngology, University of Oklahoma Medical Center, Oklahoma City, Oklahoma 73104, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23128685

Citation

Goff, Christopher J., et al. "Current Management of Congenital Branchial Cleft Cysts, Sinuses, and Fistulae." Current Opinion in Otolaryngology & Head and Neck Surgery, vol. 20, no. 6, 2012, pp. 533-9.
Goff CJ, Allred C, Glade RS. Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 2012;20(6):533-9.
Goff, C. J., Allred, C., & Glade, R. S. (2012). Current management of congenital branchial cleft cysts, sinuses, and fistulae. Current Opinion in Otolaryngology & Head and Neck Surgery, 20(6), 533-9. https://doi.org/10.1097/MOO.0b013e32835873fb
Goff CJ, Allred C, Glade RS. Current Management of Congenital Branchial Cleft Cysts, Sinuses, and Fistulae. Curr Opin Otolaryngol Head Neck Surg. 2012;20(6):533-9. PubMed PMID: 23128685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current management of congenital branchial cleft cysts, sinuses, and fistulae. AU - Goff,Christopher J, AU - Allred,Carly, AU - Glade,Robert S, PY - 2012/11/7/entrez PY - 2012/11/7/pubmed PY - 2013/5/17/medline SP - 533 EP - 9 JF - Current opinion in otolaryngology & head and neck surgery JO - Curr Opin Otolaryngol Head Neck Surg VL - 20 IS - 6 N2 - PURPOSE OF REVIEW: Branchial anomalies comprise approximately 20% of pediatric congenital head and neck lesions. This study reviews current literature detailing the diagnosis and management of first, second, third and fourth branchial cysts, sinuses and fistulae. RECENT FINDINGS: Branchial anomalies remain classified as first, second, third and fourth cysts, sinuses and fistulae. Management varies on the basis of classification. The imaging study of choice remains controversial. Computed tomography fistulography likely best demonstrates the complete course of the tract if a cutaneous opening is present. Treatment of all lesions has historically been by complete surgical excision of the entire tract. Studies of less invasive procedures for several anomalies are promising including sclerotherapy and endoscopic excision of second branchial cysts, and endoscopic cauterization or sclerotherapy at the piriform opening for third and fourth branchial sinuses. An increased risk of complications in children less than 8 years is reported in children undergoing open excision of third and fourth branchial anomalies. SUMMARY: Branchial anomalies are common congenital pediatric head and neck lesions but are comprised by several diverse anomalies. Treatment must be tailored depending on which branchial arch is involved and whether a cyst mass or sinus/fistula tract is present. SN - 1531-6998 UR - https://www.unboundmedicine.com/medline/citation/23128685/Current_management_of_congenital_branchial_cleft_cysts_sinuses_and_fistulae_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=23128685.ui DB - PRIME DP - Unbound Medicine ER -