Combined approach branchial sinusectomy: a new technique for excision of second branchial cleft sinus.
OBJECTIVE
Branchial cleft anomalies are well described, with the second arch anomaly being the commonest. Following surgical excision, recurrence occurs in 2 to 22 per cent of cases, and is believed to be due largely to incomplete resection. This report aims to describe a simple surgical technique for treatment of second branchial cleft sinus in the older paediatric age group and adults.


METHODS
An 11-year-old girl underwent surgical excision of a second branchial sinus. Prior to surgery, she was assessed by means of an imaging sonogram, and by direct methylene blue dye injection into the sinus on the operating table, followed by insertion of a metallic probe. Dissection was of the 'step ladder' incision type, but the incision was completed via an oropharyngeal approach. Histological examination of the lesion after excision established the diagnosis. No recurrence had been observed at the time of writing.


CONCLUSIONS
Although they are congenital lesions, second branchial cleft abnormalities usually present in the older paediatric age group or even in adulthood. In the case reported, a simple combined approach ensured completeness of resection.
Olusesi
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AD
Department of Ear, Nose and Throat, National Hospital, Abuja, Nigeria. biodun@nanootology.org
D001934:Branchial Region / Q000002:abnormalities / Q000601:surgery*; D002648:Child; D004396:Coloring Agents; D017577:Cutaneous Fistula / Q000601:surgery*; D005260:Female; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome
D004396:Coloring Agents