The first and second branchial syndrome refers to patients with unilateral macrostomia, hemignathia, severe ear deformity, and hypoplasia of the midfacial and temporal bones. These deformities may have a devastating effect on both patient and family, and early correction is advisable. The macrostomia should be corrected soon after birth. The hemifacial abnormality can be readily reconstructed with an autogenous dermisfat implant. Ear reconstruction should be delayed until the patient is mature enough to understand the importance of protecting the reconstructed ear.
Sessions DG, Stallings JO. First and Second Branchial Syndrome. Arch Otolaryngol. 1972;96(6):579–583. doi:10.1001/archotol.1972.00770090857017