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New classification and surgical strategy for work type I congenital first branchial cleft anomalies in children

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the anatomical relationships between the structures adjacent to the cartilaginous portion of the ear canal in children with Work type I congenital branchial cleft anomalies (CFBCAs) and to develop new classifications and surgical strategies.

Methods

Retrospective analysis was performed on 50 children with Work type I CFBCAs admitted between December 2018 and December 2022.

Results

Among the 50 children, total parotidectomy was performed on 49 sides. In 44 cases (88%), the main body of the lesion was closely associated with the cartilage of the inferior ear canal wall. Among these cases, the lesions in 40 cases occurred within the space enclosed by the dorsal inferior wall cartilage, mastoid process, and parotid gland, while in the remaining four cases, the lesions were located between the anterior inferior wall cartilage and parotid gland. Based on the preoperative imaging observations, clinical manifestations, and intraoperative findings, the cases were classified into 6 subtypes (a to f) including 21 cases (42%) of Type Ia (inferior wall of EAC), 7 cases (14%) of Type Ib (bottom wall of EAC), 12 cases (24%) of Type Ic (posterior–inferior wall of EAC), 4 cases (8%) of Type Id (anterior–inferior wall of EAC), 4 cases (8%) of Type Ie (anterior ear wall of EAC), and 2 cases (4%) of Type If (isolated from parotid).

Conclusion

Surgical intervention is the only treatment for first branchial cleft anomalies and a comprehensive understanding of the classifications will help with the precise localisation and excision of the lesions.

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Data availability

Data is available in this manuscript.

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Funding

This study was funded by the National Natural Science Foundation of China (Grant number: 82071038).

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Authors and Affiliations

  1. Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310051, Zhejiang, China

    Jing Bi, Bo Yu, Yong Fu, Bin Xu & Yang Zhang

  2. Zhejiang Provincial Key Lab of Genetic and Developmental Disorder, Hangzhou, Zhejiang, China

    Yong Fu

Authors
  1. Jing Bi
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  2. Bo Yu
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  3. Yong Fu
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  4. Bin Xu
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  5. Yang Zhang
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Contributions

Conception and design: JB, BY, and YF; administrative support: YF; provision of study materials or patients: BY, BX, and YZ; collection and assembly of data: JB and BY; data analysis and interpretation: JB and BY; manuscript writing: JB; final approval of manuscript: all the authors.

Corresponding author

Correspondence to Jing Bi.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all of the families of individual participants included in the study.

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Bi, J., Yu, B., Fu, Y. et al. New classification and surgical strategy for work type I congenital first branchial cleft anomalies in children. Eur Arch Otorhinolaryngol 280, 5539–5546 (2023). https://doi.org/10.1007/s00405-023-08140-4

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  • DOI: https://doi.org/10.1007/s00405-023-08140-4

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