Analysis of 15 cases of congenital first branchial cleft cysts and fistulas in children

YANG Cuihong; QI Feifan; GUO Zhiyong; LIU Guangping

doi:10.11958/20252736

Abstract：Objective To analyze the clinical characteristics,diagnosis and treatment of congenital first branchial cleft cysts and fistulas in children,and to improve the understanding of congenital first branchial cleft anomalies(FBCA).Methods A retrospective analysis was conducted on the data of 15 children with congenital first branchial cleft cysts and fistulas,including gender,age,medical history,side of lesion,physical examination results,preoperative imaging features,treatment methods,complication and prognosis.Results In the 15 children,there were 11 males and 4 females,aged from 1 to 12 years with a mean age of 5.4±3.1 years.The disease duration ranged from 0.5 to 72 months(with a median duration of 4 months).All cases had unilateral involvement,including 6 on the left side and 9 on the right side.There were 10 cases of cysts and 5 cases of fistulas.Two cases were of Work type Ⅱ and 13 cases were of Work type Ⅰ.The main symptoms of the children were postauricular masses or recurrent postauricular infections.All children underwent preoperative MRI examination,which showed that the lesions presented isointense or slightly long T1 and long T2 signals,and were closely related to the parotid gland or external auditory canal.All children treated with surgery and successfully completed.The intraoperative findings were consistent with the preoperative MRI indications.Postoperative pathology confirmed that all cases were consistent with the pathological manifestations of congenital branchial cleft cysts or fistulas.During the follow-up period of 5 to 20 months,no recurrence was observed in any of the 15 children.Conclusion Congenital first branchial cleft malformations in children are clinically rare.MRI has good diagnostic value and accurate surgical mapping for this condition.Complete surgical resection of the lesion can prevent recurrence and is currently the most effective treatment method.