Anatomical variations of the facial nerve in first branchial cleft anomalies

C. Arturo Solares, James Chan, Peter J. Koltai

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Objective: To review our experience with branchial cleft anomalies, with special attention to their subtypes and anatomical relationship to the facial nerve. Study Design: Case series. Setting: Tertiary care center. Patients: Ten patients who underwent resection for anomalies of the first branchial cleft, with at least 1 year of follow-up, were included in the study. The data from all cases were collected in a prospective fashion, including immediate postoperative diagrams. Intervention: Complete resection of the branchial cleft anomaly was performed in all cases. Wide exposure of the facial nerve was achieved using a modified Blair incision and superficial parotidectomy. Facial nerve monitoring was used in every case. Main Outcome Measures: The primary outcome measurements were facial nerve function and incidence of recurrence after resection of the branchial cleft anomaly. Results: Ten patients, 6 females and 4 males, with a mean age of 9 years at presentation, were treated by the senior author (P.J.K.) between 1989 and 2001. The lesions were characterized as sinus tracts (n = 5), fistulous tracts (n = 3), and cysts (n = 2). Seven lesions were medial to the facial nerve, 2 were lateral to the facial nerve, and 1 was between branches of the facial nerve. There were no complications related to facial nerve paresis or paralysis, and none of the patients has had a recurrence. Conclusions: The successful treatment of branchial cleft anomalies requires a complete resection. A safe complete resection requires a full exposure of the facial nerve, as the lesions can be variably associated with the nerve.

Original languageEnglish (US)
Pages (from-to)351-355
Number of pages5
JournalArchives of Otolaryngology - Head and Neck Surgery
Issue number3
StatePublished - Mar 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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