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Third branchial anomalies. Avoiding recurrences.
Arch Otolaryngol Head Neck Surg. 1997 Apr; 123(4):438-41.AO

Abstract

Lateral cervical cysts, sinuses, and fistulas have been described as anomalies of the normal development of the branchial apparatus. Third branchial apparatus anomalies are rare and constitute less than 1% of all such cases. Three cases of third branchial cleft cysts and sinus tracts are presented. Two patients had previously undergone multiple attempts at extirpation. Complete removal of recurrent branchial anomalies is difficult because of scarring and fascial plane disruption. Recurrences were often the result of inadequate excision, possibly of the tract communicating with the piriform sinus. To avoid this we advocate endoscopy prior to initial resection of a suspected branchial cleft anomaly to identify any pharyngeal communication. A combined, simultaneous endoscopic identification of the piriform sinus tract with a lateral external cervical dissection facilitates complete resection. In recurrent cases, wide-field extirpation of the cyst, tract, and scar tissue is necessary to ensure complete removal of the branchial cleft anomaly. A review of the literature and of branchial apparatus embryology is also presented.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9109795

Citation

Edmonds, J L., et al. "Third Branchial Anomalies. Avoiding Recurrences." Archives of Otolaryngology--head & Neck Surgery, vol. 123, no. 4, 1997, pp. 438-41.
Edmonds JL, Girod DA, Woodroof JM, et al. Third branchial anomalies. Avoiding recurrences. Arch Otolaryngol Head Neck Surg. 1997;123(4):438-41.
Edmonds, J. L., Girod, D. A., Woodroof, J. M., & Bruegger, D. E. (1997). Third branchial anomalies. Avoiding recurrences. Archives of Otolaryngology--head & Neck Surgery, 123(4), 438-41.
Edmonds JL, et al. Third Branchial Anomalies. Avoiding Recurrences. Arch Otolaryngol Head Neck Surg. 1997;123(4):438-41. PubMed PMID: 9109795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Third branchial anomalies. Avoiding recurrences. AU - Edmonds,J L, AU - Girod,D A, AU - Woodroof,J M, AU - Bruegger,D E, PY - 1997/4/1/pubmed PY - 1997/4/1/medline PY - 1997/4/1/entrez SP - 438 EP - 41 JF - Archives of otolaryngology--head & neck surgery JO - Arch. Otolaryngol. Head Neck Surg. VL - 123 IS - 4 N2 - Lateral cervical cysts, sinuses, and fistulas have been described as anomalies of the normal development of the branchial apparatus. Third branchial apparatus anomalies are rare and constitute less than 1% of all such cases. Three cases of third branchial cleft cysts and sinus tracts are presented. Two patients had previously undergone multiple attempts at extirpation. Complete removal of recurrent branchial anomalies is difficult because of scarring and fascial plane disruption. Recurrences were often the result of inadequate excision, possibly of the tract communicating with the piriform sinus. To avoid this we advocate endoscopy prior to initial resection of a suspected branchial cleft anomaly to identify any pharyngeal communication. A combined, simultaneous endoscopic identification of the piriform sinus tract with a lateral external cervical dissection facilitates complete resection. In recurrent cases, wide-field extirpation of the cyst, tract, and scar tissue is necessary to ensure complete removal of the branchial cleft anomaly. A review of the literature and of branchial apparatus embryology is also presented. SN - 0886-4470 UR - https://www.unboundmedicine.com/medline/citation/9109795/Third_branchial_anomalies__Avoiding_recurrences_ L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/vol/123/pg/438 DB - PRIME DP - Unbound Medicine ER -