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June 1988

First Branchial Cleft Anomalies: A Unifying Concept

Author Affiliations


Arch Otolaryngol Head Neck Surg. 1988;114(6):609. doi:10.1001/archotol.1988.01860180023003

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Judson R. Belmont, collaborating with investigators from Washington, DC, Birmingham, Ala, and Columbus, Ohio, retrospectively reviewed surgical and pathological findings from 11 patients with first branchial cleft anomalies. It was theorized that these anomalies are the consequence of imperfect closure of the first branchial cleft. When the ventral portion of the cleft is involved, the lesions encountered were inferior to the external auditory meatus overlying the parotid gland or in the immediate retromandibular area. The tract had variable relationship to the facial nerve. Dorsal branchial cleft anomalies resulted in duplication anomalies of the external auditory canal. Histologically, cartilage was frequently encountered. Once again, variable relationship to the facial nerve was encountered.

The authors stress that familiarity with these anomalies is critical to preoperative planning and patient counseling when surgical excision is contemplated.

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