BRANCHIAL CLEFT ANOMALIES: A PICTORIAL REVIEW
Authors:
Ana Rita Silva, Martina Leão, José Sá Silva, Isabel Breda Vazquez, Flávia Pereira, Mariana Cebotari, Teresa Burnay, Lígia Castelhano Coelho
Affiliation:
Doi: 10.54936/haoms242p50
ABSTRACT:
Introduction: The branchial arches constitute the embryological precursors of the face, neck and pharynx. Branchial cleft anomalies result from incomplete involution of the branchial apparatus and may present as cysts, sinuses, fistulae or cartilaginous remnants. These represent the second most common head and neck lesions in children, with the second cleft anomalies representing 95% of the cases, and anomalies derived from first, third and fourth clefts being rare.
Objectives: The purpose of this work is to conduct a pictorial review of a series of clinical cases diagnosed with branchial cleft anomalies, along with a review of the literature.
Materials and Methods: A review on embryological development, clinical presentation, imaging and management of branchial cleft anomalies is presented with a case series of imaging findings.
Results: Branchial cleft anomalies are present at birth and usually manifest in childhood, although it may only later become noticeable or symptomatic. These lesions can present as cysts and may be diagnosed incidentally or mistaken for other neck lesions. Sinus tracts communicate to either the skin or pharynx, being its punctum visible on the skin or internally by endoscopy. Branchial cleft fistulae connect the pharynx with the external skin. The most common anomalies are second cleft cysts that frequently manifest as a fluctuant lateral cervical mass anterior to the sternocleidomastoid muscle. Diagnostic workup includes an imaging exam such as CT or MRI, which allows appropriate characterization of the lesion and aids in surgical excision planning. Even though there are no specific imaging findings, there are typical locations that make this diagnosis extremely likely. Surgical excision is the treatment of choice and complete removal is crucial to prevent further growth and recurrence.
Conclusion: A high suspicion for branchial arch anomalies is important for proper diagnosis. Evaluation through imaging is essential for precise characterization and thereby complete surgical excision, which correlates to a good outcome.
KEY WORDS: Branchial Arches, Branchial Cleft Anomalies, Cysts, Sinus, Fistulae
Authors:
Ana Rita Silva, Martina Leão, José Sá Silva, Isabel Breda Vazquez, Flávia Pereira, Mariana Cebotari, Teresa Burnay, Lígia Castelhano Coelho
Affiliation:
Doi: 10.54936/haoms242p50
ABSTRACT:
Introduction: The branchial arches constitute the embryological precursors of the face, neck and pharynx. Branchial cleft anomalies result from incomplete involution of the branchial apparatus and may present as cysts, sinuses, fistulae or cartilaginous remnants. These represent the second most common head and neck lesions in children, with the second cleft anomalies representing 95% of the cases, and anomalies derived from first, third and fourth clefts being rare.
Objectives: The purpose of this work is to conduct a pictorial review of a series of clinical cases diagnosed with branchial cleft anomalies, along with a review of the literature.
Materials and Methods: A review on embryological development, clinical presentation, imaging and management of branchial cleft anomalies is presented with a case series of imaging findings.
Results: Branchial cleft anomalies are present at birth and usually manifest in childhood, although it may only later become noticeable or symptomatic. These lesions can present as cysts and may be diagnosed incidentally or mistaken for other neck lesions. Sinus tracts communicate to either the skin or pharynx, being its punctum visible on the skin or internally by endoscopy. Branchial cleft fistulae connect the pharynx with the external skin. The most common anomalies are second cleft cysts that frequently manifest as a fluctuant lateral cervical mass anterior to the sternocleidomastoid muscle. Diagnostic workup includes an imaging exam such as CT or MRI, which allows appropriate characterization of the lesion and aids in surgical excision planning. Even though there are no specific imaging findings, there are typical locations that make this diagnosis extremely likely. Surgical excision is the treatment of choice and complete removal is crucial to prevent further growth and recurrence.
Conclusion: A high suspicion for branchial arch anomalies is important for proper diagnosis. Evaluation through imaging is essential for precise characterization and thereby complete surgical excision, which correlates to a good outcome.
KEY WORDS: Branchial Arches, Branchial Cleft Anomalies, Cysts, Sinus, Fistulae