title: Intraoperative use of fibrin glue dyed with methylene blue in surgery for branchial cleft anomalies.
abstract: We present a new method of optimizing the results of surgery for branchial cleft anomalies based on the intraoperative injection of fibrin glue combined with methylene blue dye.
  
  
  
  Retrospective single-center cohort study.
  
  
  
  The method was applied in 17 patients suffering from branchial anomalies. Six (35.29%) had a preauricular lesion; three (17.65%) had lesions derived from the first arch/pouch/groove (type I), four (23.53%) had lesions derived from the first (type II), one (5.88%) had lesions derived from the second, one (5.88%) had lesions derived from the third, and two (11.76%) had lesions derived from the fourth. The median and mean age at surgery were 10 and 10.6 years, respectively. All patients were followed by periodic clinical and ultrasonographic examination.
  
  
  
  The combination of fibrin glue with methylene blue facilitated the correct assessment of the extension of the lesions and their intraoperative manipulation. After a mean follow-up of 47.8 months, all patients were free of disease.
  
  
  
  Intraoperative injection of branchial fistulae and cysts by a mixture of fibrin glue and methylene blue is an effective, easy, and safe tool to track lesions and achieve radical resection. The technique requires a definitive validation on a large cohort with adequate stratification of patients.
  
  
  
  4 Laryngoscope, 126:2147-2150, 2016.
authors.affiliation: Department of Pediatric Otolaryngology, Spedali Civili, Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Piccioni
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bottazzoli
authors.affiliation: Department of Pediatric Otolaryngology, Spedali Civili, Brescia, Italy.
authors.forename: Nader
authors.initials: N
authors.lastname: Nassif
authors.affiliation: Department of Pediatric Otolaryngology, Spedali Civili, Brescia, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Stefini
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000293:Adolescent; D000328:Adult; D001934:Branchial Region / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004396:Coloring Agents / Q000008:administration & dosage; D019465:Craniofacial Abnormalities / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage; D010608:Pharyngeal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D015718:Fibrin Tissue Adhesive; D008751:Methylene Blue
keywords: Branchial cyst; branchial fistula; fibrin glue; methylene blue