Congenital second branchial cleft anomalies in children: A report of 52 surgical cases, with emphasis on characteristic CT findings

Wei Chen; Yilong Zhou; Mengrou Xu; Rong Xu; Qingyu Wang; Hongming Xu; Jiarui Chen; Xiaoyan Li

doi:10.3389/fped.2023.1088234

Congenital second branchial cleft anomalies in children: A report of 52 surgical cases, with emphasis on characteristic CT findings

Front Pediatr. 2023 Mar 3:11:1088234. doi: 10.3389/fped.2023.1088234. eCollection 2023.

Authors

Wei Chen¹, Yilong Zhou², Mengrou Xu¹, Rong Xu³, Qingyu Wang⁴, Hongming Xu¹, Jiarui Chen¹, Xiaoyan Li¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Department of Pediatric Otorhinolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
³ Department of Radiology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁴ Department of Pathology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Objective: The objectives of this study was to review the clinical features and surgical treatment outcomes of congenital second branchial cleft anomalies (CSBCAs) and to investigate the characteristic computed tomography (CT) findings of CSBCAs.

Methods: We conducted a retrospective study of 52 children who were referred to Shanghai Children's Hospital from October 2014 to December 2021 diagnosed as CSBCAs.

Results: There were 36 males and 16 females. Of them, 35 patients were presented as having a skin pit at birth or discharge from the skin opening on the lateral neck, and 17 patients presented with an asymptomatic or painful mass. The typical CT features of CSBCAs included isolated and homogeneously hypodense cystic lesions surrounded by a uniformly thin, smooth wall. CSBCAs were generally located at the anteromedial border of the sternocleidomastoid muscle, posterior to the submandibular gland, and lateral to the carotid sheath. All patients were treated surgically and only one case underwent ipsilateral tonsillectomy. After a median follow-up of 30 (range 4-90) months, no recurrence or complications were observed.

Conclusions: The CSBCAs show some characteristic CT findings, which can help clinicians diagnose and plan surgical strategies. High ligation of the lesions is sufficient for complete excision of CSBCAs.

Keywords: Bailey classification; carotid sheath; congenital second branchial cleft anomalies; sternocleidomastoid muscle; submandibular gland.

Grants and funding

This study was funded by the Shanghai Shenkang Hospital Development Center Municipal Hospital Clinical Research Cultivation Project (grant no. SHDC12019X21) and the National Natural Science Foundation of China (grant no. 82171121).