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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Branchial cleft cyst (BCC)
Synonyms
- Pharyngeal cleft anomaly = branchial cleft anomaly (BCA)
- Pharyngeal apparatus = branchial apparatus (cleft, arch, & pouch)
Definitions
- 1st branchial cleft anomaly: Most are cysts or sinuses; fistula from skin to external auditory canal (EAC) or middle ear rare
- 1st BCC: Benign, congenital cyst in or adjacent to parotid gland, 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 & cartilaginous pinna
- Skin (ectodermal cleft) & cartilage (mesodermal arch) origin
- May also have contribution from 2nd arch
- Less commonly used classification
- Arnot type I: Derived from buried rests of 1st branchial cleft (BC); intraparotid cyst or sinus
- Arnot type II: Secondary to incomplete closure 1st BC
- Cyst or sinus in anterior triangle of neck ± communication with EAC
- Remnant of 1st branchial apparatus: Most commonly used classification
- 1st BC sinus tract opens near parotid gland, EAC, parapharyngeal space, or anterior triangle of neck
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
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
- Friedman E et al: Imaging of pediatric salivary glands. Neuroimaging Clin N Am. 28(2):209-26, 2018
- Schmidt R et al: Management of first branchial cleft anomalies via a cartilage-splitting technique. Otolaryngol Head Neck Surg. 152(6):1149-51, 2015
- Shinn JR et al: First branchial cleft anomalies: otologic manifestations and treatment outcomes. Otolaryngol Head Neck Surg. 152(3):506-12, 2015
- Gonzalez-Perez LM et al: Bilateral first branchial cleft anomaly with evidence of a genetic aetiology. Int J Oral Maxillofac Surg. 43(3):296-300, 2014
- Maithani T et al: First branchial cleft anomaly: clinical insight into its relevance in otolaryngology with pediatric considerations. Indian J Otolaryngol Head Neck Surg. 66(Suppl 1):271-6, 2014
- Bajaj Y et al: Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 75(8):1020-3, 2011
- Johnson JM et al: Syndromes of the first and second branchial arches, part 1: embryology and characteristic defects. AJNR Am J Neuroradiol. 32(1):14-9, 2011
- Johnson JM et al: Syndromes of the first and second branchial arches, part 2: syndromes. AJNR Am J Neuroradiol. 32(2):230-7, 2011
- 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
- Nicollas R et al: Unusual association of congenital middle ear cholesteatoma and first branchial cleft anomaly: management and embryological concepts. Int J Pediatr Otorhinolaryngol. 69(2):279-82, 2005
- Nicollas R et al: Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol. 55(2):117-24, 2000
- 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
- Harnsberger HR et al: Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 152(3):739-48, 1984
- Pediatric Parotid Region Lesions: An Imaging Review
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Branchial cleft cyst (BCC)
Synonyms
- Pharyngeal cleft anomaly = branchial cleft anomaly (BCA)
- Pharyngeal apparatus = branchial apparatus (cleft, arch, & pouch)
Definitions
- 1st branchial cleft anomaly: Most are cysts or sinuses; fistula from skin to external auditory canal (EAC) or middle ear rare
- 1st BCC: Benign, congenital cyst in or adjacent to parotid gland, 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 & cartilaginous pinna
- Skin (ectodermal cleft) & cartilage (mesodermal arch) origin
- May also have contribution from 2nd arch
- Less commonly used classification
- Arnot type I: Derived from buried rests of 1st branchial cleft (BC); intraparotid cyst or sinus
- Arnot type II: Secondary to incomplete closure 1st BC
- Cyst or sinus in anterior triangle of neck ± communication with EAC
- Remnant of 1st branchial apparatus: Most commonly used classification
- 1st BC sinus tract opens near parotid gland, EAC, parapharyngeal space, or anterior triangle of neck
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
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
- Friedman E et al: Imaging of pediatric salivary glands. Neuroimaging Clin N Am. 28(2):209-26, 2018
- Schmidt R et al: Management of first branchial cleft anomalies via a cartilage-splitting technique. Otolaryngol Head Neck Surg. 152(6):1149-51, 2015
- Shinn JR et al: First branchial cleft anomalies: otologic manifestations and treatment outcomes. Otolaryngol Head Neck Surg. 152(3):506-12, 2015
- Gonzalez-Perez LM et al: Bilateral first branchial cleft anomaly with evidence of a genetic aetiology. Int J Oral Maxillofac Surg. 43(3):296-300, 2014
- Maithani T et al: First branchial cleft anomaly: clinical insight into its relevance in otolaryngology with pediatric considerations. Indian J Otolaryngol Head Neck Surg. 66(Suppl 1):271-6, 2014
- Bajaj Y et al: Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 75(8):1020-3, 2011
- Johnson JM et al: Syndromes of the first and second branchial arches, part 1: embryology and characteristic defects. AJNR Am J Neuroradiol. 32(1):14-9, 2011
- Johnson JM et al: Syndromes of the first and second branchial arches, part 2: syndromes. AJNR Am J Neuroradiol. 32(2):230-7, 2011
- 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
- Nicollas R et al: Unusual association of congenital middle ear cholesteatoma and first branchial cleft anomaly: management and embryological concepts. Int J Pediatr Otorhinolaryngol. 69(2):279-82, 2005
- Nicollas R et al: Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol. 55(2):117-24, 2000
- 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
- Harnsberger HR et al: Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 152(3):739-48, 1984
- Pediatric Parotid Region Lesions: An Imaging Review
