Abstract：
OBJECTIVE: Branchial cleft anomalies (BCAs) are common pediatric head and neck lesions; however, only 1-4% involve the first branchial cleft. The rare occurrence of first BCAs, their presentation at a young age, and the possible facial nerve involvement make diagnosis and treatment challenging.
METHODS: A retrospective chart review was conducted for children diagnosed with their first BCA between 2000 and 2020. Data on demographics, presenting symptoms, physical findings, imaging features, previous surgery, and treatment outcomes were collected and analyzed.
RESULTS: The cohort included 17 patients with a median age of 5 years at presentation. Seven (41%) had undergone previous surgical intervention before definitive surgery. Eight were classified as Work Type II anomalies, and nine as Work Type I. Sixteen patients (94%) underwent definitive surgical excision at a median age of 6.9. A parotid approach was used in 10 (62%), with dissection of the mass from the facial nerve, and a retro-auricular or end-aural approach was used in 6 (38%). Complete excision was achieved in 14/16 patients (88%). Three patients had transient facial nerve paresis postoperatively. Recurrence was noted in 3/16 patients (18%). Enhancement in imaging was positively correlated with post-operative complications (R = 0.463, P = 0.018).
CONCLUSIONS: First, BCA poses a diagnostic and surgical challenge; thus, definitive surgical treatment is often delayed. The surgical approach should be tailored to the type of anomaly (Work type I or II) and possible facial nerve involvement. Risk factors for post-operative complications are a history of recurrent infections and previous surgical interventions. The presence of contrast enhancement in preoperative imaging should alert surgeons to perioperative challenges and the risk of post-operative complications.
METHODS:
METHODS: A retrospective chart review was conducted for children diagnosed with their first BCA between 2000 and 2020. Data on demographics, presenting symptoms, physical findings, imaging features, previous surgery, and treatment outcomes were collected and analyzed.
RESULTS: The cohort included 17 patients with a median age of 5 years at presentation. Seven (41%) had undergone previous surgical intervention before definitive surgery. Eight were classified as Work Type II anomalies, and nine as Work Type I. Sixteen patients (94%) underwent definitive surgical excision at a median age of 6.9. A parotid approach was used in 10 (62%), with dissection of the mass from the facial nerve, and a retro-auricular or end-aural approach was used in 6 (38%). Complete excision was achieved in 14/16 patients (88%). Three patients had transient facial nerve paresis postoperatively. Recurrence was noted in 3/16 patients (18%). Enhancement in imaging was positively correlated with post-operative complications (R = 0.463, P = 0.018).
CONCLUSIONS: First, BCA poses a diagnostic and surgical challenge; thus, definitive surgical treatment is often delayed. The surgical approach should be tailored to the type of anomaly (Work type I or II) and possible facial nerve involvement. Risk factors for post-operative complications are a history of recurrent infections and previous surgical interventions. The presence of contrast enhancement in preoperative imaging should alert surgeons to perioperative challenges and the risk of post-operative complications.
METHODS:
摘要：
目的：支气管裂异常（BCAs）是小儿头颈部常见的病变；只有1-4％的人出现在第一支裂中。第一次BCA的罕见发生，他们在年轻时的演讲，面神经受累的可能性使诊断和治疗具有挑战性。
方法：对2000年至2020年间诊断为首次BCA的儿童进行回顾性图表回顾。人口统计数据，出现症状，物理发现，成像特征,以前的手术，收集和分析治疗结果.
结果：该队列包括17名患者，中位年龄为5岁。在确定性手术之前，有7人（41％）曾接受过手术干预。八个被归类为II型工作异常，工作类型I有9例（94％），中位年龄为6.9岁，接受了明确的手术切除。10例（62%）采用腮腺入路，从面神经解剖肿块，6例(38%)采用耳后或耳端入路。14/16例患者（88％）实现了完全切除。3例患者术后出现短暂性面神经麻痹。3/16例患者（18％）复发。影像学增强与术后并发症呈正相关(R=0.463,P=0.018)。
结论：首先，BCA提出了诊断和手术挑战；因此，明确的手术治疗通常会延迟。手术方法应根据异常类型（工作类型I或II）和可能的面神经受累进行调整。术后并发症的危险因素是复发感染史和以前的手术干预。术前成像中对比增强的存在应提醒外科医生注意围手术期的挑战和术后并发症的风险。
方法：
方法：对2000年至2020年间诊断为首次BCA的儿童进行回顾性图表回顾。人口统计数据，出现症状，物理发现，成像特征,以前的手术，收集和分析治疗结果.
结果：该队列包括17名患者，中位年龄为5岁。在确定性手术之前，有7人（41％）曾接受过手术干预。八个被归类为II型工作异常，工作类型I有9例（94％），中位年龄为6.9岁，接受了明确的手术切除。10例（62%）采用腮腺入路，从面神经解剖肿块，6例(38%)采用耳后或耳端入路。14/16例患者（88％）实现了完全切除。3例患者术后出现短暂性面神经麻痹。3/16例患者（18％）复发。影像学增强与术后并发症呈正相关(R=0.463,P=0.018)。
结论：首先，BCA提出了诊断和手术挑战；因此，明确的手术治疗通常会延迟。手术方法应根据异常类型（工作类型I或II）和可能的面神经受累进行调整。术后并发症的危险因素是复发感染史和以前的手术干预。术前成像中对比增强的存在应提醒外科医生注意围手术期的挑战和术后并发症的风险。
方法：
