Most common 1st branchial cleft anomalies (BCAs) are branchial cleft cysts (BCCs) or sinuses
1st BCC: Benign, congenital cyst in or adjacent to parotid gland, external auditory canal (EAC), or pinna
Remnant of 1st branchial apparatus: Most commonly used classification
Work type I: Duplication of membranous EAC; ectodermal (cleft) origin
Work type II: Duplication of membranous EAC and cartilaginous pinna
Skin (ectodermal cleft) and cartilage (mesodermal arch) origin
May also have contribution from 2nd arch
1st branchial cleft sinus tract opens near parotid gland, EAC, parapharyngeal space (PPS), or anterior triangle of neck
IMAGING
Ultrasonographic Findings
CT Findings
MR Findings
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Bansal AG et al: US of pediatric superficial masses of the head and neck. Radiographics. 38(4):1239-1263, 2018
ScienceDirect: Type II first branchial cyst and sinus excision with preservation of facial nerve and parotid gland. https://doi.org/10.1016/j.epsc.2013.02.008. Reviewed November 1, 2018. Accessed November 1, 2018.
Adams A et al: Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings. Insights Imaging. 7(1):69-76, 2016
Ankur G et al: First branchial cleft cyst (type II). Ear Nose Throat J. 88(11):1194-5, 2009
Gupta AK et al: Bilateral first and second branchial cleft fistulas: a case report. Ear Nose Throat J. 87(5):291-3, 2008
Martinez Del Pero M et al: Presentation of first branchial cleft anomalies: the Sheffield experience. J Laryngol Otol. 121(5):455-9, 2007
Schroeder JW Jr et al: Branchial anomalies in the pediatric population. Otolaryngol Head Neck Surg. 137(2):289-95, 2007
Koch BL: Cystic malformations of the neck in children. Pediatr Radiol. 35(5):463-77, 2005
Gritzmann N et al: Sonography of soft tissue masses of the neck. J Clin Ultrasound. 30(6):356-73, 2002
Nicollas R et al: Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol. 55(2):117-24, 2000
Robson CD et al: Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings. AJNR Am J Neuroradiol. 20(10):1829-35, 1999
Sichel JY et al: Clinical update on type II first branchial cleft cysts. Laryngoscope. 108(10):1524-7, 1998
Triglia JM et al: First branchial cleft anomalies: a study of 39 cases and a review of the literature. Arch Otolaryngol Head Neck Surg. 124(3):291-5, 1998
Nofsinger YC et al: Periauricular cysts and sinuses. Laryngoscope. 107(7):883-7, 1997
Van der Goten A et al: First branchial complex anomalies: report of 3 cases. Eur Radiol. 7(1):102-5, 1997
Arndal H et al: First branchial cleft anomaly. Clin Otolaryngol. 21(3):203-7, 1996
Choi SS et al: Branchial anomalies: a review of 52 cases. Laryngoscope. 105(9 Pt 1):909-13, 1995
Mukherji SK et al: Evaluation of first branchial anomalies by CT and MR. J Comput Assist Tomogr. 17(4):576-81, 1993
Benson MT et al: Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 12(5):943-60, 1992
Doi O et al: Branchial remnants: a review of 58 cases. J Pediatr Surg. 23(9):789-92, 1988
Finn DG et al: First branchial cleft cysts: clinical update. Laryngoscope. 97(2):136-40, 1987
Graham MD et al: First branchial cleft cyst presenting as a mass within the external auditory canal. Am J Otol. 6(6):500-2, 1985
Sherman NH et al: Ultrasound evaluation of neck masses in children. J Ultrasound Med. 4(3):127-34, 1985
Harnsberger HR et al: Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 152(3):739-48, 1984
Olsen KD et al: First branchial cleft anomalies. Laryngoscope. 90(3):423-36, 1980
Wilson DB: Embryonic development of the head and neck: part 2, the branchial region. Head Neck Surg. 2(1):59-66, 1979
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KEY FACTS
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TERMINOLOGY
Synonyms
Branchial apparatus cysts
Definitions
Most common 1st branchial cleft anomalies (BCAs) are branchial cleft cysts (BCCs) or sinuses
1st BCC: Benign, congenital cyst in or adjacent to parotid gland, external auditory canal (EAC), or pinna
Remnant of 1st branchial apparatus: Most commonly used classification
Work type I: Duplication of membranous EAC; ectodermal (cleft) origin
Work type II: Duplication of membranous EAC and cartilaginous pinna
Skin (ectodermal cleft) and cartilage (mesodermal arch) origin
May also have contribution from 2nd arch
1st branchial cleft sinus tract opens near parotid gland, EAC, parapharyngeal space (PPS), or anterior triangle of neck
IMAGING
Ultrasonographic Findings
CT Findings
MR Findings
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Bansal AG et al: US of pediatric superficial masses of the head and neck. Radiographics. 38(4):1239-1263, 2018
ScienceDirect: Type II first branchial cyst and sinus excision with preservation of facial nerve and parotid gland. https://doi.org/10.1016/j.epsc.2013.02.008. Reviewed November 1, 2018. Accessed November 1, 2018.
Adams A et al: Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings. Insights Imaging. 7(1):69-76, 2016
Ankur G et al: First branchial cleft cyst (type II). Ear Nose Throat J. 88(11):1194-5, 2009
Gupta AK et al: Bilateral first and second branchial cleft fistulas: a case report. Ear Nose Throat J. 87(5):291-3, 2008
Martinez Del Pero M et al: Presentation of first branchial cleft anomalies: the Sheffield experience. J Laryngol Otol. 121(5):455-9, 2007
Schroeder JW Jr et al: Branchial anomalies in the pediatric population. Otolaryngol Head Neck Surg. 137(2):289-95, 2007
Koch BL: Cystic malformations of the neck in children. Pediatr Radiol. 35(5):463-77, 2005
Gritzmann N et al: Sonography of soft tissue masses of the neck. J Clin Ultrasound. 30(6):356-73, 2002
Nicollas R et al: Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol. 55(2):117-24, 2000
Robson CD et al: Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings. AJNR Am J Neuroradiol. 20(10):1829-35, 1999
Sichel JY et al: Clinical update on type II first branchial cleft cysts. Laryngoscope. 108(10):1524-7, 1998
Triglia JM et al: First branchial cleft anomalies: a study of 39 cases and a review of the literature. Arch Otolaryngol Head Neck Surg. 124(3):291-5, 1998
Nofsinger YC et al: Periauricular cysts and sinuses. Laryngoscope. 107(7):883-7, 1997
Van der Goten A et al: First branchial complex anomalies: report of 3 cases. Eur Radiol. 7(1):102-5, 1997
Arndal H et al: First branchial cleft anomaly. Clin Otolaryngol. 21(3):203-7, 1996
Choi SS et al: Branchial anomalies: a review of 52 cases. Laryngoscope. 105(9 Pt 1):909-13, 1995
Mukherji SK et al: Evaluation of first branchial anomalies by CT and MR. J Comput Assist Tomogr. 17(4):576-81, 1993
Benson MT et al: Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 12(5):943-60, 1992
Doi O et al: Branchial remnants: a review of 58 cases. J Pediatr Surg. 23(9):789-92, 1988
Finn DG et al: First branchial cleft cysts: clinical update. Laryngoscope. 97(2):136-40, 1987
Graham MD et al: First branchial cleft cyst presenting as a mass within the external auditory canal. Am J Otol. 6(6):500-2, 1985
Sherman NH et al: Ultrasound evaluation of neck masses in children. J Ultrasound Med. 4(3):127-34, 1985
Harnsberger HR et al: Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 152(3):739-48, 1984
Olsen KD et al: First branchial cleft anomalies. Laryngoscope. 90(3):423-36, 1980
Wilson DB: Embryonic development of the head and neck: part 2, the branchial region. Head Neck Surg. 2(1):59-66, 1979
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