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Conservative management as a viable alternative in the management of paediatric first branchial arch fistula: a case series

Published online by Cambridge University Press:  11 November 2024

Adam Garrard Open the ORCID record for Adam Garrard [Opens in a new window] ,
Nathan Walker Open the ORCID record for Nathan Walker [Opens in a new window] ,
Kris Milinis ,
Sarah Mortaja  and
Sunil Sharma
Adam Garrard*
Affiliation:
Ear Nose and Throat Department, Alder Hey Children’s Hospital, Liverpool, KE, UK
Nathan Walker
Affiliation:
Ear Nose and Throat Department, Alder Hey Children’s Hospital, Liverpool, KE, UK
Kris Milinis
Affiliation:
Ear Nose and Throat Department, Alder Hey Children’s Hospital, Liverpool, KE, UK
Sarah Mortaja
Affiliation:
Ear Nose and Throat Department, Alder Hey Children’s Hospital, Liverpool, KE, UK
Sunil Sharma
Affiliation:
Ear Nose and Throat Department, Alder Hey Children’s Hospital, Liverpool, KE, UK
*
Corresponding author: Adam Garrard; Email: adam.garrard@nhs.net
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Abstract

Objectives

First branchial arch abnormalities are rare. Surgical excision is the mainstay of treatment and described in the literature. Excision can be associated with significant complications. We describe factors influencing operative and non-operative management of patients.

Methods

Case review was conducted between January 2012 and September 2022 of patients with first branchial arch abnormalities at Alder Hey Children’s Hospital, UK. Analysis of electronic patient records, operation notes and extraction of clinical outcomes were obtained.

Results

Four patients were identified with an average age of 2 years and 4 months. Three were female. Three underwent operative intervention, one of which had a recurrence post-operatively and was manged conservatively. The non-operatively managed patient remains conservatively managed with no complications.

Conclusion

First branchial arch abnormalities can be managed operatively and non-operatively, depending on patient factors. Steps to improve surgical planning such as constructive interference in steady state magnetic resonance imaging may help decision making and risk stratification of operative management.

Keywords

branchial archbranchial cleft cystbranchial cleftsconservative treatmentfacial nerve injuries

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 5 , May 2025 , pp. 377 - 382
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Adam Garrard takes responsibility for the integrity of the content of the paper

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