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Journal of Ultrasonography Mar 2022Branchial anomalies result from incomplete obliteration of the branchial arch structures during embryogenesis. Second branchial arch anomalies are commonly found on the...
AIM OF THE STUDY
Branchial anomalies result from incomplete obliteration of the branchial arch structures during embryogenesis. Second branchial arch anomalies are commonly found on the lower third of the neck, with an opening at the anterior border of the sternocleidomastoid muscle, and may drain secretions or purulent material. This case demonstrates the use of handheld point-of-care ultrasound to aid in the diagnosis of a branchial anomaly.
CASE DESCRIPTION
The patient presented with a "hole" in the neck with intermittent drainage from the site. A 2 mm defect in the skin was noted anterior to the sternocleidomastoid muscle. A handheld ultrasound system was used to identify a well-defined, hypoechoic, cyst-like structure. Given the history, physical findings, and point-of-care ultrasound imaging, the diagnosis of a second branchial cleft sinus was made.
CONCLUSIONS
The use of point-of-care ultrasound and knowledge of the sonographic characteristics of these lesions can assist the physician in the diagnosis of branchial arch anomalies.
PubMed: 35449698
DOI: 10.15557/JoU.2022.0012 -
The Journal of Craniofacial SurgerySurgical removal is the treatment of choice for second branchial cleft cysts (SBCCs), which are congenital anomalies. The conventional procedure is performed through a... (Meta-Analysis)
Meta-Analysis
Surgical removal is the treatment of choice for second branchial cleft cysts (SBCCs), which are congenital anomalies. The conventional procedure is performed through a transcervical approach, which would lead to a visible scar in the anterior neck. Conversely, the postauricular approach could keep the scar in the hairline or retroauricular sulcus, rendering it almost invisible after the surgery. The purpose of this meta-analysis was to evaluate the differences between the postauricular and conventional transcervical approaches to SBCC excision. A systematic review was performed using PubMed, Embase, and the Cochrane Library to identify studies comparing outcomes of SBCC surgery via postauricular and conventional transcervical approaches. The data of interest were analyzed with Comprehensive Meta-Analysis software (version 3). The data of interest were analyzed by calculating the risk difference (RD), the standardized mean difference, and the mean difference (MD) with the 95% confidence interval (CI). Three studies were eligible for the final analysis. The pooled analysis demonstrated that the cosmetic satisfaction score was significantly higher with the postauricular approach (standardized mean difference, 2.12; 95% CI, 0.68-3.56). The operative duration was significantly longer with the postauricular approach than with the conventional transcervical approach (MD, 12.81; 95% CI, 2.39-23.23). The incidences of postoperative marginal mandibular nerve palsy (RD, 0.00; 95% CI, -0.09 to 0.09), bleeding complications (RD, -0.02; 95% CI, -0.09 to 0.05), salivary complications (RD, -0.00; 95% CI, -0.07 to 0.06), cyst size (MD, 0.02; 95% CI, -0.96-0.99), and length of hospital stay (MD, -2.50; CI, -7.30 to 2.30) were comparable between the 2 groups. The postauricular approach is feasible for use in SBCC excision and yields better cosmetic outcomes, a longer operative duration, and a similar rate of complications.
Topics: Humans; Branchioma; Cicatrix; Treatment Outcome; Neck Dissection; Head and Neck Neoplasms; Surgical Wound
PubMed: 35882056
DOI: 10.1097/SCS.0000000000008741 -
British Medical Journal Nov 1949
Topics: Branchioma; Fistula; Head and Neck Neoplasms; Humans
PubMed: 15393042
DOI: 10.1136/bmj.2.4635.1025-a -
Kulak Burun Bogaz Ihtisas Dergisi : KBB... 2015Hydatid cyst disease is a parasitic infestation caused by Echinococcus granulosus. It is transmitted via oral ingestion of eggs excreted by dog's stool. Liver and lungs...
Hydatid cyst disease is a parasitic infestation caused by Echinococcus granulosus. It is transmitted via oral ingestion of eggs excreted by dog's stool. Liver and lungs are the most commonly involved organs. Primary involvement of submandibular region by hydatid cyst is extremely rare. In this article, we report a case of a lesion excised from submandibular region with an initial diagnosis of branchial cleft cyst, but shown to be a hydatid cyst in histopathological evaluation.
Topics: Animals; Branchioma; Child, Preschool; Diagnosis, Differential; Echinococcosis; Echinococcus granulosus; Female; Head and Neck Neoplasms; Humans; Lymphatic Diseases; Neck
PubMed: 26476521
DOI: 10.5606/kbbihtisas.2015.04317 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Feb 2020The aim of this study is to evaluate the value of multi-slice spiral CT (CT) and multi-planar reconstruction (MPR) in the diagnosis of children with parotid...
The aim of this study is to evaluate the value of multi-slice spiral CT (CT) and multi-planar reconstruction (MPR) in the diagnosis of children with parotid cleft deformity. The CT images of 55 cases of branchial cleft deformity confirmed by surgery and pathology were retrospectively analyzed. CT examination showed that 37 cases had strip-like, tubular fistula or cystic mass located in the anterior cervical triangle, anterior margin of sternocleidomastoid muscle, and 2 of them had bilateral fistula structure. In 16 casescystic mass and tubular fistula were found in the parotid gland or at the edge of the parotid gland. One case was accompanied by atresia of the lateral auditory meatus. After contrast enhancement, the cystic wall(tube wall) of 55 patients were enhanced. In 9 patients with infection, the boundary of the lesion was blurred, and the density of the cyst or lumen increased after contrast enhancement. MSCT diagnosed 6 cases of parotid cleft cyst with fistula, 35 cases of branchial cleft cyst, 13 cases of parotid fistula, and 1 case misdiagnosed as lymphadenitis. Among all the cases, 15 were type Ⅰ, 36 were type Ⅱand 4 were type Ⅲ. Compared with the results of pathological diagnosis and clinical operation, the accuracy of qualitative diagnosis and localization was 99.9% and 100.0%. Multi-slice spiral CT thin-slice images combined with MPR image post-processing technology can better display the location of branchial cyst and the course of branchial fistula.
Topics: Branchioma; Child; Head and Neck Neoplasms; Humans; Parotid Gland; Retrospective Studies; Tomography, Spiral Computed
PubMed: 32086920
DOI: 10.13201/j.issn.1001-1781.2020.02.011 -
The Annals of Otology, Rhinology, and... Apr 2022During the last 2 decades, new treatment methods have been developed for the surgical removal of second branchial cysts which result in less visible scars. The aim of... (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
During the last 2 decades, new treatment methods have been developed for the surgical removal of second branchial cysts which result in less visible scars. The aim of this systematic review is to assess which surgical technique for second branchial arch cyst removal results in the lowest complication and recurrence rates with the highest scar satisfaction.
METHODS
Two authors systematically reviewed the literature in the Cochrane, PubMed, and EMBASE databases (search date: 1975 to December 2nd, 2020) to identify studies comparing surgical outcomes of second branchial arch cyst removal. Authors appraised selected studies on directness of evidence and risk of bias. Results are reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
RESULTS
Out of the 2442 retrieved articles, 4 articles were included in the current review including a total of 140 operated cysts. Only 2 studies included pre-operatively infected cysts. Follow up ranged from 3 to 24 months. Complication rates ranged from 0 to 27.3% (conventional: [0-10.4%]; endoscopic/retro-auricular: [0-27.3%]). None of the patients presented with postoperative recurrence. Significantly higher scar satisfaction was found in adult patients who underwent endoscopic or retro-auricular hairline incision cyst removal.
CONCLUSION
No recurrence of disease occurred during (at least) 3 months of follow up using either conventional surgery or endoscopic/retro-auricular techniques. Although more (temporary) complications occur using endoscopic and retro-auricular techniques, patients report a significantly higher scar satisfaction 3 to 6 months after surgery in comparison to the conventional technique. Future studies are needed to support these findings.
Topics: Branchioma; Head and Neck Neoplasms; Humans; Neoplasms, Second Primary
PubMed: 34137276
DOI: 10.1177/00034894211024049 -
Dento Maxillo Facial Radiology Dec 2012A branchial cleft cyst (BCC) commonly presents as a solitary, painless mass in the neck of a child or young adult. They are most commonly located along the anterior... (Review)
Review
A branchial cleft cyst (BCC) commonly presents as a solitary, painless mass in the neck of a child or young adult. They are most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck. It is very rare for a BCC to manifest in other locations, especially in the posterior triangle of the neck. BCCs are believed to be derived from the branchial apparatus, mostly from the second branchial arch, although many theories have been proposed to explain the aetiology of BCCs. It is possible for BCCs to be easily misdiagnosed as other swellings of oral or paraoral origin owing to their location. Intraoral lymphoepithelial cysts have also been reported in the literature. It is imperative that clinicians make an accurate diagnosis so that appropriate treatment can be performed. If the cysts are excised properly, recurrence is rare. A rare case report of BCC arising in the neck from an unusual location with components in the posterior triangle is presented here.
Topics: Branchioma; Child; Contrast Media; Diagnosis, Differential; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Jugular Veins; Neck Muscles; Radiographic Image Enhancement; Submandibular Gland; Tomography, X-Ray Computed
PubMed: 22116133
DOI: 10.1259/dmfr/59515421 -
Acta Otorrinolaringologica Espanola 2015Cystic lesions of the posterior triangle are a pathologic entity whose diagnosis is made in the first two years of life. Its presentation in adulthood is an incidental...
Cystic lesions of the posterior triangle are a pathologic entity whose diagnosis is made in the first two years of life. Its presentation in adulthood is an incidental finding and the differential diagnosis includes cystic lymphangioma, lymphatic metastasis of thyroid cancer and branchial cyst. Often with the finding of a cervical lump, FNA is made before diagnostic imaging is performed, however, this procedure is not always advisable. We reviewed the cases of patients who came last year to our department with a cystic mass in this location and correlating the imaging findings with pathologic specimen. We show characteristic findings of these lesions in order to make an early diagnosis and thus to get the approach and treatment appropriate of adult patients with a cystic lesion in the posterior cervical triangle.
Topics: Adult; Branchioma; Carcinoma, Papillary; Cysts; Female; Head and Neck Neoplasms; Humans; Lymphangioma; Magnetic Resonance Imaging; Male; Neck; Retrospective Studies; Thyroid Neoplasms; Tomography, X-Ray Computed; Ultrasonography; Young Adult
PubMed: 24846559
DOI: 10.1016/j.otorri.2014.02.013 -
Medecine Et Sante Tropicales 2015Branchial cysts are rare, benign cervical lesions that can mimic thyroid goiters, in particular in areas where goiters are endemic. This case describes an Ivorian...
Branchial cysts are rare, benign cervical lesions that can mimic thyroid goiters, in particular in areas where goiters are endemic. This case describes an Ivorian patient who presented with what appeared to be a voluminous thyroid goiter. At surgery, it proved to be a cyst of the second pharyngeal arch.
Topics: Adult; Branchioma; Diagnosis, Differential; Female; Goiter, Nodular; Head and Neck Neoplasms; Humans
PubMed: 26039459
DOI: 10.1684/mst.2015.0445 -
Singapore Medical Journal Apr 2015The objective of the present study was to review the distribution and incidence of branchial anomalies in an Asian paediatric population and highlight the challenges...
INTRODUCTION
The objective of the present study was to review the distribution and incidence of branchial anomalies in an Asian paediatric population and highlight the challenges involved in the diagnosis of branchial anomalies.
METHODS
This was a retrospective chart review of all paediatric patients who underwent surgery for branchial anomalies in a tertiary paediatric hospital from August 2007 to November 2012. The clinical notes were correlated with preoperative radiological investigations, intraoperative findings and histology results. Branchial anomalies were classified based on the results of the review.
RESULTS
A total of 28 children underwent surgery for 30 branchial anomalies during the review period. Two children had bilateral branchial anomalies requiring excision. Of the 30 branchial anomalies, 7 (23.3%) were first branchial anomalies, 5 (16.7%) were second branchial anomalies, 3 (10.0%) were third branchial anomalies, and 4 (13.3%) were fourth branchial anomalies (one of the four patients with fourth branchial anomalies had bilateral branchial anomalies). In addition, seven children had 8 (26.7%) branchial anomalies that were thought to originate from the pyriform sinus; however, we were unable to determine if these anomalies were from the third or fourth branchial arches. There was inadequate information on the remaining 3 (10.0%) branchial anomalies for classification.
CONCLUSION
The incidence of second branchial anomalies appears to be lower in our Asian paediatric population, while that of third and fourth branchial anomalies was higher. Knowledge of embryology and the related anatomy of the branchial apparatus is crucial in the identification of the type of branchial anomaly.
Topics: Adolescent; Branchial Region; Branchioma; Child; Child, Preschool; Female; Hospitals, Pediatric; Humans; Incidence; Infant; Male; Retrospective Studies; Singapore
PubMed: 25917471
DOI: 10.11622/smedj.2015060