Anatomical variations of the facial nerve in first branchial cleft anomalies.
OBJECTIVE
To review our experience with branchial cleft anomalies, with special attention to their subtypes and anatomical relationship to the facial nerve.


METHODS
Case series.


METHODS
Tertiary care center.


METHODS
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.


METHODS
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.


METHODS
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.
Solares
C Arturo
CA
Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, OH 44195, USA.
Chan
James
J
Koltai
Peter J
PJ
D000293:Adolescent; D000328:Adult; D001934:Branchial Region / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005154:Facial Nerve / Q000033:anatomy & histology* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies