title: First branchial cleft anomalies: avoiding the misdiagnosis.
abstract: First branchial cleft anomalies are a very rare entities accounting for less than 1 % of all branchial cleft malformations. They are often misdiagnosed for other cystic lesions occurring in parotid gland and inadequately treated (incision and drainage or incomplete excision) leading to multiple recurrences. We report a series of four patients who were previously operated (incision and drainage) for misdiagnosed first branchial cleft anomalies with subsequent recurrences. All patients underwent superficial parotidectomy with complete tract excision using facial nerve monitoring to prevent iatrogenic injury because of extensive fibrosis. We discuss the literature pertaining to first branchial cleft anomalies, their varied presentations and their relationship to facial nerve in parotid gland and importance of facial nerve monitoring in revision surgery.
authors.affiliation: Department of ENT and Head and Neck Surgery, AIIMS, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of ENT and Head and Neck Surgery, AIIMS, New Delhi, India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Sikka
authors.affiliation: Department of ENT and Head and Neck Surgery, AIIMS, New Delhi, India.
authors.forename: Prem
authors.initials: P
authors.lastname: Sagar
authors.affiliation: Department of Pathology, AIIMS, New Delhi, India.
authors.forename: Aanchal
authors.initials: A
authors.lastname: Kakkar
authors.affiliation: Department of ENT and Head and Neck Surgery, AIIMS, New Delhi, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
keywords: Facial nerve; Facial nerve monitoring; First branchial cleft anamolies; Superficial parotidectomy