A Clinical Study of Branchial Anomaly

Tae, Kyung; Jeong, Seung Won; Lee, Eung Jun; Lee, Seung Hwan; Kim, Kyung Rae; Park, Chu Won; Lee, Hyung Seok

Abstract

BACKGROUND AND OBJECTIVES: The branchial anomaly is a lateral neck mass commonly seen by otolaryngologists. Although somewhat controversial, almost all surgeons agree that lateral cervical cyst, fistula and sinus are of branchogenic origin. Depending on its anatomic location, branchial anomaly can be classified into first, second, third and fourth. The purpose of this study is to evaluate the clinical and pathologic manifestations of branchial anomaly and to determine proper diagnosis and treatment. MATERIALS AND METHOD: With a review of charts, we retrospectively analyzed 46 cases of the branchial anomaly who had been treated at the Hanyang University Medical Center between 1991 and 2001. Age, sex, site of lesion, classification, surgical therapy, radiologic and pathologic findings and post-operative surgical complications were reviewed.
RESULTS
The second branchial cyst was the most common anomaly. Patients were commonly seen in the 3rd and 4th decades. Compared with cysts, the fistulas and sinuses were detected relatively at the younger age. Twenty five per cent of patients were presented in the infected state, and 45 cases were treated with complete surgical excision; there were no major post-operative complications and recurrence.
CONCLUSION
An accurate diagnosis is crucial in the management of branchial anomaly to prevent recurrence and multiple surgical procedures. Although clinical examination and history are the most important factors suggesting the diagnosis of branchial anomaly, preoperative radiologic evaluation can be used to determine the nature and extent of the branchial anomaly. After control of acute inflammation or abscess, the complete surgical excision is crucial for a successful outcome.