title: Surgical management of first branchial cleft anomaly presenting as infected retroauricular mass using a microscopic dissection technique.
abstract: OBJECTIVE
  This is a detailed description of the clinical and anatomical presentation of the first branchial cleft anomaly presenting as retroauricular infected mass. Our experience with a microscopic dissection with control of the sinus lumen from within the cyst is also described.
  
  
  METHODS
  Between 2001 and 2008, patients with the final histologic diagnosis of first branchial cleft anomaly in the retroauricular area were managed with a microscopic dissection technique with control of the sinus lumen from within the cyst. Classifications were done in accordance with Work, Olsen, and Chilla. Outcomes measured intervention as a function of disease recurrence and complications including facial nerve function was used.
  
  
  RESULTS
  Eight patients with a mean age of 14.2 years were enrolled, and this included 4 females and 4 males. Four type 1 and 4 type 2 lesions as per the Work's and Chilla's classification were found, and there were 5 sinuses, 2 fistulae, and 1 cyst according to Olsen's classification. All patients presented to the department with acute infection at the time of diagnosis. Five of the 8 patients had previous surgical treatment, 2 of those had up to 3 previous operations. None of the patients were complicated by disease recurrence or had surgical related complications (facial nerve paresis or paralysis, infection, canal stenosis) requiring reoperation with more than 1 year of follow-up.
  
  
  CONCLUSIONS
  First branchial cleft anomaly presenting as retroauricular infected mass can be effectively treated by adopting a microscopic dissection technique with control of the sinus lumen from within the cyst.
authors.affiliation: Department of Otolaryngology, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou, Taiwan.
authors.forename: Kai-Chieh
authors.initials: KC
authors.lastname: Chan
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Chao
authors.forename: Che-Ming
authors.initials: CM
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D001934:Branchial Region / Q000002:abnormalities* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000601:surgery; D004210:Dissection / Q000379:methods; D005260:Female; D005402:Fistula / Q000601:surgery; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome