Department of Otolaryngology - Head and Neck Surgery, McGill University, Quebec, Canada.
Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France.
J Otolaryngol Head Neck Surg. 2020 May 29;49(1):32. doi: 10.1186/s40463-020-00426-5.
First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives.
A 6-year-old boy presented to us with a left conductive hearing loss associated with pre-tympanic keratin debris and an ipsilateral painful cervical mass. He had a past medical history of left ear surgery for presumed cholesteatoma 2 years prior and left neck abscess drainage 6 months prior. CT and MRI revealed a lesion originating in the external auditory canal and extending cervically through a bony canal located medial to the facial nerve and terminating as a parapharyngeal cyst. The complete removal was accomplished in one surgical stage consisting of three distinct steps: robotic assisted transoral resection of the pharyngeal cyst, an endaural approach and a parotidectomy approach.
We believe that our detailed description of this rare first branchial cleft cyst with pharyngeal extension, possibly a hybrid case between a first and second branchial cyst, can serve as a valuable tool to Otolaryngologists - Head and Neck Surgeons who come across a similar unusual presentations.
第一鳃裂畸形较为罕见，仅占所有鳃裂畸形的 10%。我们报告了一个更为罕见且独特的第一、二鳃弓衍生结构均存在的鳃裂囊肿病例。
一名 6 岁男孩因左侧传导性听力损失就诊，伴前鼓室角蛋白碎片和同侧颈痛性肿块。他既往有左侧耳手术史（2 年前诊断为胆脂瘤）和左侧颈部脓肿引流史（6 个月前）。CT 和 MRI 显示病变起源于外耳道，通过面神经内侧的骨性通道向颈部延伸，最终形成咽旁囊肿。通过三个不同步骤的单一手术阶段完成了完全切除：机器人辅助经口咽囊肿切除术、耳内镜入路和腮腺切除术。
我们认为，我们对这个罕见的具有咽腔延伸的第一鳃裂囊肿（可能是第一和第二鳃裂囊肿的混合病例）的详细描述，可以为遇到类似不典型表现的耳鼻喉科-头颈外科医生提供有价值的工具。
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