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Background <p>First branchial cleft anomalies are uncommon paediatric congenital lesions that may present as persistent pre-auricular or post-auricular sinuses and can involve the parotid region and facial nerve. We present a single-centre 10-year experience describing presentation, imaging, management and outcomes.</p> Methods <p>Retrospective review of a prospectively collected local dataset of paediatric patients with first branchial arch cleft cysts/tracts who underwent evaluation and surgery at a tertiary paediatric centre. Data elements included age at presentation, presenting symptoms, imaging modality, surgical treatment, postoperative complications, facial nerve dysfunction, fistula course, recurrence and follow-up.</p> Results <p>Eleven patients were included (mean age 5.55 years, median 4 years). The commonest presentation was a persistent sinus with purulent discharge (9/11). Laterality was predominantly left-sided (8/11). MRI was the most used imaging modality (8/11). Postoperative wound infection occurred in 3/11 patients (27%); marginal mandibular branch weakness was recorded in 2/11 (both documented as transient/resolved). One patient had documented recurrence. The fistula/tract most commonly tracked from level II to the ear canal (9/11).</p> Conclusion <p>In this paediatric series, first branchial arch cleft anomalies most commonly presented as persistent left-sided sinuses with purulent discharge. MRI was commonly used for preoperative assessment. Surgical excision was associated with wound infection in a minority and transient marginal mandibular weakness in several cases. Larger multi-centre series with systematic prospective follow-up are needed.</p>

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First branchial cleft cysts in a UK paediatric tertiary centre: A 10-year single-centre case series

  • 期刊论文

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  • 发表日期：

    2026年2月9日

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  • Sofia Anastasiadou,
  • Paris Bruno,
  • Oliver Dale,
  • Julian Gaskin

摘要

Background

First branchial cleft anomalies are uncommon paediatric congenital lesions that may present as persistent pre-auricular or post-auricular sinuses and can involve the parotid region and facial nerve. We present a single-centre 10-year experience describing presentation, imaging, management and outcomes.

Methods

Retrospective review of a prospectively collected local dataset of paediatric patients with first branchial arch cleft cysts/tracts who underwent evaluation and surgery at a tertiary paediatric centre. Data elements included age at presentation, presenting symptoms, imaging modality, surgical treatment, postoperative complications, facial nerve dysfunction, fistula course, recurrence and follow-up.

Results

Eleven patients were included (mean age 5.55 years, median 4 years). The commonest presentation was a persistent sinus with purulent discharge (9/11). Laterality was predominantly left-sided (8/11). MRI was the most used imaging modality (8/11). Postoperative wound infection occurred in 3/11 patients (27%); marginal mandibular branch weakness was recorded in 2/11 (both documented as transient/resolved). One patient had documented recurrence. The fistula/tract most commonly tracked from level II to the ear canal (9/11).

Conclusion

In this paediatric series, first branchial arch cleft anomalies most commonly presented as persistent left-sided sinuses with purulent discharge. MRI was commonly used for preoperative assessment. Surgical excision was associated with wound infection in a minority and transient marginal mandibular weakness in several cases. Larger multi-centre series with systematic prospective follow-up are needed.