Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-

Abstract Background First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives. Case presentation A 6-year-old boy presented to us wi...

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Main Authors: A. Fanous, V. Couloigner, P. Gorphe, L. Galmiche, M. Alexandru, E-N Garabedian, L. Coffinet, T. Blanc, N. Leboulanger, F. Denoyelle
Format: Article
Language:English
Published: SAGE Publishing 2020-05-01
Series:Journal of Otolaryngology - Head and Neck Surgery
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Online Access:http://link.springer.com/article/10.1186/s40463-020-00426-5
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author A. Fanous
V. Couloigner
P. Gorphe
L. Galmiche
M. Alexandru
E-N Garabedian
L. Coffinet
T. Blanc
N. Leboulanger
F. Denoyelle
author_facet A. Fanous
V. Couloigner
P. Gorphe
L. Galmiche
M. Alexandru
E-N Garabedian
L. Coffinet
T. Blanc
N. Leboulanger
F. Denoyelle
author_sort A. Fanous
collection DOAJ
description Abstract Background First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives. Case presentation A 6-year-old boy presented to us with a left conductive hearing loss associated with pre-tympanic keratin debris and an ipsilateral painful cervical mass. He had a past medical history of left ear surgery for presumed cholesteatoma 2 years prior and left neck abscess drainage 6 months prior. CT and MRI revealed a lesion originating in the external auditory canal and extending cervically through a bony canal located medial to the facial nerve and terminating as a parapharyngeal cyst. The complete removal was accomplished in one surgical stage consisting of three distinct steps: robotic assisted transoral resection of the pharyngeal cyst, an endaural approach and a parotidectomy approach. Conclusion We believe that our detailed description of this rare first branchial cleft cyst with pharyngeal extension, possibly a hybrid case between a first and second branchial cyst, can serve as a valuable tool to Otolaryngologists – Head and Neck Surgeons who come across a similar unusual presentations.
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institution Kabale University
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spelling doaj-art-22871568bb364a949eb7a8f1b28608ee2025-08-20T03:54:48ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162020-05-014911510.1186/s40463-020-00426-5Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-A. Fanous0V. Couloigner1P. Gorphe2L. Galmiche3M. Alexandru4E-N Garabedian5L. Coffinet6T. Blanc7N. Leboulanger8F. Denoyelle9Department of Otolaryngology - Head and Neck Surgery, McGill UniversityDepartment of Pediatric Otolaryngology – Head and Neck Surgery, Hôpital Necker – Enfants Malades – Paris V UniversityDepartment of Otolaryngology – Head and Neck Surgery, Institut Gustave RoussyPathology Department, Hôpital Necker – Enfants Malades – Paris V UniversityDepartment of Pediatric Otolaryngology – Head and Neck Surgery, Hôpital Necker – Enfants Malades – Paris V UniversityDepartment of Pediatric Otolaryngology – Head and Neck Surgery, Hôpital Necker – Enfants Malades – Paris V UniversityDepartment of Otolaryngology – Head and Neck Surgery, Centre Hospitalier Régional et Universitaire de Nancy, Hôpital CentralDepartment of Pediatric Surgery, Hôpital Necker – Enfants Malades – Paris V UniversityDepartment of Pediatric Otolaryngology – Head and Neck Surgery, Hôpital Necker – Enfants Malades – Paris V UniversityDepartment of Pediatric Otolaryngology – Head and Neck Surgery, Hôpital Necker – Enfants Malades – Paris V UniversityAbstract Background First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives. Case presentation A 6-year-old boy presented to us with a left conductive hearing loss associated with pre-tympanic keratin debris and an ipsilateral painful cervical mass. He had a past medical history of left ear surgery for presumed cholesteatoma 2 years prior and left neck abscess drainage 6 months prior. CT and MRI revealed a lesion originating in the external auditory canal and extending cervically through a bony canal located medial to the facial nerve and terminating as a parapharyngeal cyst. The complete removal was accomplished in one surgical stage consisting of three distinct steps: robotic assisted transoral resection of the pharyngeal cyst, an endaural approach and a parotidectomy approach. Conclusion We believe that our detailed description of this rare first branchial cleft cyst with pharyngeal extension, possibly a hybrid case between a first and second branchial cyst, can serve as a valuable tool to Otolaryngologists – Head and Neck Surgeons who come across a similar unusual presentations.http://link.springer.com/article/10.1186/s40463-020-00426-5First branchialCholesteatomaRoboticCystParapharyngeal
spellingShingle A. Fanous
V. Couloigner
P. Gorphe
L. Galmiche
M. Alexandru
E-N Garabedian
L. Coffinet
T. Blanc
N. Leboulanger
F. Denoyelle
Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-
Journal of Otolaryngology - Head and Neck Surgery
First branchial
Cholesteatoma
Robotic
Cyst
Parapharyngeal
title Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-
title_full Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-
title_fullStr Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-
title_full_unstemmed Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-
title_short Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report-
title_sort unusual presentation of a first branchial cleft cyst associated with an abnormal bony canal a case report
topic First branchial
Cholesteatoma
Robotic
Cyst
Parapharyngeal
url http://link.springer.com/article/10.1186/s40463-020-00426-5
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