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Branchial Cleft Anomalies
Bernadette L. Koch, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Branchial cleft cyst, branchial apparatus cyst (BAC), branchial apparatus anomaly (BAA)
          • Definitions

            • Anomaly/remnant of embryologic endodermal pouch, mesodermal arch, or ectodermal cleft
            • May be cyst, fistula, or sinus tract

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Pupić-Bakrač J et al: Branchial cleft anomalies: hybrid "branchial inclusion" theory. Eur Arch Otorhinolaryngol. 278(7):2593-601, 2021
                                  2. Kang B et al: Congenital midline cervical cleft: an easily misdiagnosed disease. Arch Craniofac Surg. 21(6):372-5, 2020
                                  3. King J et al: Computed tomography findings of complete branchial cleft fistula. Ear Nose Throat J. ePub, 2020
                                  4. Li WX et al: Surgical treatment of fourth branchial apparatus anomalies: a case series study. J Otolaryngol Head Neck Surg. 49(1):79, 2020
                                  5. Liu H et al: Clinical Manifestations, diagnosis, and management of first branchial cleft fistula/sinus: a case series and literature review. J Oral Maxillofac Surg. 78(5):749-61, 2020
                                  6. Liu W et al: Clinical analysis of type ii first branchial cleft anomalies in children. Laryngoscope. 131(4):916-20, 2020
                                  7. Magdy EA et al: Unusual isolated parapharyngeal second branchial cleft cyst: a case report and literature review. Case Rep Otolaryngol. 2020:8814071, 2020
                                  8. Maksimoski M et al: Combination surgical procedure for fourth branchial anomalies: operative technique and outcomes. Ann Otol Rhinol Laryngol. 3489420971674, 2020
                                  9. Rossi ME et al: Fourth branchial anomalies: predictive factors of therapeutic success. J Pediatr Surg. 54(8):1702-7, 2019
                                  10. 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
                                  11. Shinn JR et al: First branchial cleft anomalies: otologic manifestations and treatment outcomes. Otolaryngol Head Neck Surg. 152(3):506-12, 2015
                                  12. Goff CJ et al: Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 20(6):533-9, 2012
                                  13. Thomas B et al: Revisiting imaging features and the embryologic basis of third and fourth branchial anomalies. AJNR Am J Neuroradiol. 31(4):755-60, 2010
                                  14. Sturm-O'Brien AK et al: Cervical thymic anomalies--the Texas Children's Hospital experience. Laryngoscope. 119(10):1988-93, 2009
                                  15. Koch BL: Cystic malformations of the neck in children. Pediatr Radiol. 35(5):463-77, 2005
                                  16. Mukherji SK et al: Imaging of congenital anomalies of the branchial apparatus. Neuroimaging Clin N Am. 10(1):75-93, viii, 2000
                                  17. Benson MT et al: Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 12(5):943-60, 1992
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Synonyms

                                            • Branchial cleft cyst, branchial apparatus cyst (BAC), branchial apparatus anomaly (BAA)
                                          • Definitions

                                            • Anomaly/remnant of embryologic endodermal pouch, mesodermal arch, or ectodermal cleft
                                            • May be cyst, fistula, or sinus tract

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              DIAGNOSTIC CHECKLIST

                                                              • Consider

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Pupić-Bakrač J et al: Branchial cleft anomalies: hybrid "branchial inclusion" theory. Eur Arch Otorhinolaryngol. 278(7):2593-601, 2021
                                                                  2. Kang B et al: Congenital midline cervical cleft: an easily misdiagnosed disease. Arch Craniofac Surg. 21(6):372-5, 2020
                                                                  3. King J et al: Computed tomography findings of complete branchial cleft fistula. Ear Nose Throat J. ePub, 2020
                                                                  4. Li WX et al: Surgical treatment of fourth branchial apparatus anomalies: a case series study. J Otolaryngol Head Neck Surg. 49(1):79, 2020
                                                                  5. Liu H et al: Clinical Manifestations, diagnosis, and management of first branchial cleft fistula/sinus: a case series and literature review. J Oral Maxillofac Surg. 78(5):749-61, 2020
                                                                  6. Liu W et al: Clinical analysis of type ii first branchial cleft anomalies in children. Laryngoscope. 131(4):916-20, 2020
                                                                  7. Magdy EA et al: Unusual isolated parapharyngeal second branchial cleft cyst: a case report and literature review. Case Rep Otolaryngol. 2020:8814071, 2020
                                                                  8. Maksimoski M et al: Combination surgical procedure for fourth branchial anomalies: operative technique and outcomes. Ann Otol Rhinol Laryngol. 3489420971674, 2020
                                                                  9. Rossi ME et al: Fourth branchial anomalies: predictive factors of therapeutic success. J Pediatr Surg. 54(8):1702-7, 2019
                                                                  10. 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
                                                                  11. Shinn JR et al: First branchial cleft anomalies: otologic manifestations and treatment outcomes. Otolaryngol Head Neck Surg. 152(3):506-12, 2015
                                                                  12. Goff CJ et al: Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 20(6):533-9, 2012
                                                                  13. Thomas B et al: Revisiting imaging features and the embryologic basis of third and fourth branchial anomalies. AJNR Am J Neuroradiol. 31(4):755-60, 2010
                                                                  14. Sturm-O'Brien AK et al: Cervical thymic anomalies--the Texas Children's Hospital experience. Laryngoscope. 119(10):1988-93, 2009
                                                                  15. Koch BL: Cystic malformations of the neck in children. Pediatr Radiol. 35(5):463-77, 2005
                                                                  16. Mukherji SK et al: Imaging of congenital anomalies of the branchial apparatus. Neuroimaging Clin N Am. 10(1):75-93, viii, 2000
                                                                  17. Benson MT et al: Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 12(5):943-60, 1992