title: External auditory canal duplication anomalies associated with congenital aural atresia.
abstract: Maldevelopment of the first branchial cleft can produce a broad spectrum of anomalies in its derivative structure, the external auditory canal (EAC). Failure of the cleft to develop normally can result in either the absence of a normally patent EAC (atresia, or stenosis) or a duplication anomaly (cyst, sinus, or fistula). Despite their common origins, the coexistence of these anatomical abnormalities is quite unusual. We present four patients with both aural atresia and duplication anomalies of the EAC. Three patients had non-syndromic unilateral aural atresia and presented with periauricular lesions originating from the first branchial cleft. The other patient had a variant of Treacher Collins syndrome and presented with draining infra-auricular fistulae. The classification and management of first branchial cleft anomalies is reviewed in light of these cases. An understanding of the embryogenesis of the external ear is necessary to successfully recognize and treat this spectrum of deformities. A classification system is presented that encompasses the full spectrum of first cleft anomalies.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, New England Medicine, Boston, MA 02111, USA. nblevins@lifespan.org
authors.forename: Nikolas H
authors.initials: NH
authors.lastname: Blevins
authors.forename: Seema V
authors.initials: SV
authors.lastname: Byahatti
authors.forename: Collin S
authors.initials: CS
authors.lastname: Karmody
mesh_terms: D000328:Adult; D002648:Child; D004424:Ear Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D004431:Ear, External / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008342:Mandibulofacial Dysostosis / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods