Branchial anomalies in the pediatric population.
OBJECTIVE
We sought to review the presentation, evaluation, and treatment of branchial anomalies in the pediatric population and to relate these findings to recurrences and complications.


METHODS
We conducted a retrospective study at a tertiary care pediatric hospital.


METHODS
Ninety-seven pediatric patients who were treated for branchial anomalies over a 10-year period were reviewed. Patients were studied if they underwent surgical treatment for the branchial anomaly and had 1 year of postoperative follow-up; 67 children met criteria, and 74 anomalies were studied.


RESULTS
Patients with cysts presented at a later age than did those with branchial anomaly fistulas or sinus branchial anomalies. 32% of branchial anomalies were previously infected. Of these, 71% had more than one preoperative infection. 18% of the BA were first arch derivatives, 69% were second arch derivatives and 7% were third arch derivatives. There were 22 branchial cysts, 31 branchial sinuses and 16 branchial fistulas. The preoperative and postoperative diagnoses differed in 17 cases. None of the excised specimens that contained a cystic lining recurred; all five recurrences had multiple preoperative infections.


CONCLUSIONS
Recurrence rates are increased when there are multiple preoperative infections and when there is no epithelial lining identified in the specimen.
Division of Pediatric Otolaryngology, Department of Surgery, Children's Memorial Hospital, Northwestern University, Chicago, IL 60614, USA. jschroeder@childrensmemorial.org
James W
JW
Schroeder
Nadia
N
Mohyuddin
John
J
Maddalozzo
D001934:Branchial Region / Q000002:abnormalities* / Q000601:surgery*; D001935:Branchioma / Q000601:surgery; D002675:Child, Preschool; D005260:Female; D005402:Fistula / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome