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Congenital first branchial cleft anomalies in children: a study of 100 surgical cases and a review of the literature

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Abstract

Objective

To investigate the clinical features and surgical outcomes of pediatric congenital first branchial cleft anomalies (CFBCAs).

Methods

We conducted a retrospective analysis of 100 children who were referred to Shanghai Children’s Hospital from March 2014 to March 2022 for the treatment of CFBCAs.

Results

This study included 100 patients (33 males, 67 females) with an average age of 4.0 ± 2.7 years. 64 cases were type I FBCAs and 36 were type II. The main clinical manifestations included having a skin pit or discharge from it (62%), painless masses (5%), mucopurulent otorrhea (8%) and recurrent swelling with pain (90%) in the Pochet’s triangle area. 92% had infection histories, 84% had incision and drainage histories, and 18% had surgical histories. 6 cases of tympanic membranous attachment were found by auricular endoscopy. Ultrasonography (US) was 55.6% (30/54) accurate and enhanced CT was 75% (75/100) accurate in diagnosing CFBCAs. We dissected the facial nerve (FN) in 46% cases. Lesions ended in the external auditory canal (EAC) wall in 86 cases. 69 exhibited close relationship with the parotid. The patients were followed up 0.25–8.2 years. 11 had postoperative temporary facial paralysis and all improved within 6 months. 3 had recurrence and they were secondarily successfully retreated. No EAC stenosis were found.

Conclusions

CFBCAs often presented with repeated swelling and purulence in Pochet’s triangle. CT, US and auricular endoscopy can assist in diagnosis and planning the surgical strategy. Complete excision in non-infection stage as soon as possible is the first choice for the treatment of CFBCAs.

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Funding

Shanghai Shenkang hospital development center municipal hospital clinical research cultivation project (SHDC12019X21).

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Luding Road, No. 355, PuTuo District, Shanghai, 200062, China

    Wei Chen, Mengrou Xu, Jiarui Chen, Hongming Xu & Xiaoyan Li

  2. Department of Pathology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai, 200062, China

    Qingyu Wang

  3. Department of Radiology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai, 200062, China

    Rong Xu

Authors
  1. Wei Chen
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  2. Mengrou Xu
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  3. Qingyu Wang
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  4. Rong Xu
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  5. Jiarui Chen
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  6. Hongming Xu
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  7. Xiaoyan Li
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Each of the authors has contributed to read and approved this manuscript.

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Correspondence to Xiaoyan Li.

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Chen, W., Xu, M., Wang, Q. et al. Congenital first branchial cleft anomalies in children: a study of 100 surgical cases and a review of the literature. Eur Arch Otorhinolaryngol 280, 425–433 (2023). https://doi.org/10.1007/s00405-022-07607-0

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  • DOI: https://doi.org/10.1007/s00405-022-07607-0

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