Clinical Analysis of Branchial Anomalies：A Review of 72 Cases

Korean Journal of Head & Neck Oncology 2009;25(1):12-17.
Published online May 30, 2009.

Moo-Pil Kim;Hwan Choei;Se-Jin Park;Eun-Jae Chung;Seung-Kuk Baek;Jeong-Soo Woo;Soon-Young Kwon;Nam-Joon Lee;Kwang-Yoon Jung

새성기형에 관한 임상적 고찰

김무필;최 환;박세진;정은재;백승국;우정수;권순영;이남준;정광윤

Abstract

Background and Objectives ：Branchial anomaly is a common neck pathology seen by otolaryngologist. Al-though there is still controversy regarding the origin, almost all surgeon agree that branchial anomalies result from incomplete involution of the branchial apparatus. Depending on its anatomic location, branchial ano-malies can be classified into first, second, third and fourth anomaly. The purpose of this study is to evaluate the incidence of different categories of branchial anomalies and to determine proper method of diagnosis and treatment. Subjects and Method ：A retrospective chart review was conducted for 72 patients with branchial anomalies operated on at the Korea University Anam Hospital from 1996 to 2007. The patient’s sex, age, presenting symptoms, classification, site of lesion, diagnostic studies, surgical therapy and post-operative surgical complication were reviewed.
Results
：Patients were commonly seen in the 3rd decades. Eleven patients(15.3%) were first branchial anomalies, 52(72.2%) were second, 1(1.4%) was third, and 8(11.1%) were fourth. Of the types of anomalies, cyst were most commonly seen. In cases of 3rd and 4th branchial anomalies, barium contrast study can de-lineate the course of sinus or fistula. All cases was operated on for branchial anomalies, there were no major post-operative complication.
Conclusion
：Cervical mass and recurrent cervical infection or abscess are suspect for branchial anomalies. Especially, clinical history of dysphagia, and recurrent painful swelling in the thyroid region in young patients should raise the suspicion of 3rd and 4th branchial anomalies. Careful history, clinical examination and radio-graphic study were essential parts in diagnosis of branchial anomalies. Although surgical management of bran-chial anomalies depend on its type, nature and extent, complete excision is the major surgical procedure.

Key Words: Branchial anomalies, Branchial cleftSinus, Fistula