SECOND BRANCHIAL CLEFT ANOMALIES: ANALYSIS OF OUR CLINICAL EXPERIENCE IN 10 YEARS

Material and Methods: The patients diagnosed with branchial cyst or fistula and managed surgically between January 2008 and December 2018 in the otolaryngology department of a tertiary academic center were reviewed retrospectively.

Results: The files of 43 cases with second branchial cleft anomaly were examined. Of these, 39 (90.7%) were cysts and 4 (9.3%) were fistulas. The mean age was 24±13(3-66) years. The main complaint was swelling mass at the neck in all cases(100%). 4 (9.3%) had a history of infected cysts. The mean size of the cysts was 3.29±1.94(2-9.5) cm. Fine needle aspiration cytology(FNAC) was performed in 17 (39.53%) of the cases. Atypical cells- suspicion of malignancy was reported at FNAC of 4 (23.5%) cases, and of 13 cases (76.5%) were reported as benign. In our FNAC series, the false positives has a rate of 23.5%. As the most advanced imaging method, ultrasonography (USG), computed tomography(CT) and magnetic resonance imaging (MRI) were performed in 13 (30.3%), 11 (25.5%) and 19 (44.1%) cases respectively. USG only was performed as the most advanced imaging method in 50% of the patients in 2008, however in 2018, 3 (75%) of the cases were evaluated with MRI and 1 (25%) case was evaluated with CT. Surgical excision of the cyst or fistula tract excision under general anesthesia was performed for treatment in all cases. Surgical pathology was consistent with branchial cyst or fistula in all cases. Superficial skin infection occurred in 2 (4.6%) patients in the postoperative period. No recurrence was detected in the follow-up period (0%).

Conclusion: CT and MRI for imaging of second branchial cleft anomalies, and FNAC differentiation from other malignant cystic lesions has become more commonly used over the years. Surgical treatment is the treatment of choice for second branchial cleft anomalies. The complication and recurrence rates are very low with appropriate surgical excision. Keywords : Branchial cleft anomaly, second branchial cleft cyst, second branchial fistula