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Anatomical variations of the facial nerve in first branchial cleft anomalies Solares CA; Chan J; Koltai PJArch Otolaryngol Head Neck Surg 2003[Mar]; 129 (3): 351-5OBJECTIVE: To review our experience with branchial cleft anomalies, with special attention to their subtypes and anatomical relationship to the facial nerve. STUDY DESIGN: Case series. SETTING: Tertiary care center. PATIENTS: Ten patients who underwent resection for anomalies of the first branchial cleft, with at least 1 year of follow-up, were included in the study. The data from all cases were collected in a prospective fashion, including immediate postoperative diagrams. INTERVENTION: Complete resection of the branchial cleft anomaly was performed in all cases. Wide exposure of the facial nerve was achieved using a modified Blair incision and superficial parotidectomy. Facial nerve monitoring was used in every case. MAIN OUTCOME MEASURES: The primary outcome measurements were facial nerve function and incidence of recurrence after resection of the branchial cleft anomaly. RESULTS: Ten patients, 6 females and 4 males,with a mean age of 9 years at presentation, were treated by the senior author (P.J.K.) between 1989 and 2001. The lesions were characterized as sinus tracts (n = 5), fistulous tracts (n = 3), and cysts (n = 2). Seven lesions were medial to the facial nerve, 2 were lateral to the facial nerve, and 1 was between branches of the facial nerve. There were no complications related to facial nerve paresis or paralysis, and none of the patients has had a recurrence. CONCLUSIONS: The successful treatment of branchial cleft anomalies requires a complete resection. A safe complete resection requires a full exposure of the facial nerve, as the lesions can be variably associated with the nerve.|Adolescent[MESH]|Adult[MESH]|Branchial Region/*abnormalities/surgery[MESH]|Child[MESH]|Child, Preschool[MESH]|Facial Nerve/*anatomy & histology/physiology[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Prospective Studies[MESH] |
