ABSTRACT
Periauricular cysts, sinuses, and fistulas occur commonly in the pediatric population. They arise from developmental defects of the first branchial cleft and first branchial arch. In most instances the diagnosis and management of these conditions are straightforward, but exceptional presentations sometimes occur. Failure to recognize these unusual cases may result in inadequate treatment and subsequent recurrence, and even if the correct diagnosis is made, surgical management of these lesions may be complicated. A series of 15 cases of periauricular congenital lesions is reviewed, of which three cases illustrating a diagnostic or surgical challenge are presented. The embryology, presentation, and management of these anomalies are discussed. This is one of the largest series of first branchial cleft anomalies reported in the literature, and our paper uniquely discusses first branchial cleft anomalies and preauricular sinuses together, with an emphasis on the surgical management of facial nerve, external ear, and middle ear involvement.
Subject(s)
Branchial Region/abnormalities , Branchioma/congenital , Ear Diseases/congenital , Ear Neoplasms/congenital , Branchial Region/embryology , Branchial Region/surgery , Branchioma/embryology , Branchioma/surgery , Child, Preschool , Ear Diseases/embryology , Ear Diseases/surgery , Ear Neoplasms/embryology , Ear Neoplasms/surgery , Female , Humans , Infant , Male , Neoplasm Recurrence, Local , RecurrenceABSTRACT
A series of nine cases of first branchial cleft anomalies treated at Children's Hospital of Michigan from 1970-1978 is presented. A review of the literature and analysis of these cases reveals that the accepted criteria for classification of these anomalies are confusing and inadequate as they preclude the proper classification of a number of these cases. The embryogenesis of these anomalies is discussed with attention given to their relationship to the facial nerve. A proper classification is suggested.
Subject(s)
Branchial Region , Branchioma , Adolescent , Adult , Branchioma/embryology , Child , Child, Preschool , Congenital Abnormalities , Ear Neoplasms/congenital , Ear Neoplasms/embryology , Facial Nerve/embryology , Female , Humans , Infant , Infant, Newborn , Male , PregnancyABSTRACT
We report a case of an odontoma of the middle ear cavity. A brief description of odontomas and their development is given with an embryologic account of middle ear cleft development. The developmental relationships of a nasopharyngeal odontoma, an odontogenic craniopharyngioma, and an otic odontoma are presented.
Subject(s)
Deafness/etiology , Ear Neoplasms/complications , Ear, Middle , Odontogenic Tumors/complications , Odontoma/complications , Child , Ear Neoplasms/diagnostic imaging , Ear Neoplasms/embryology , Ear, Middle/abnormalities , Ear, Middle/diagnostic imaging , Humans , Male , Odontoma/diagnostic imaging , Odontoma/embryology , RadiographyABSTRACT
A brief review of the embryology and anatomy of first branchial cleft cysts and sinuses, with a resume of our experience, is presented. An illustrative case of each general type of this anomaly is given. The surgical treatment of these lesions, with special reference to technique and the precautions to be applied to minimize complications and recurrence, is discussed.
