Clinical presentation of first branchial clefts anomalies

Background - The rarity and diverse presentations of first branchial cleft anomalies lead to misdiagnosis and inadequate treatment. Population and methods. We report 21 cases of such anomalies in children aged 7 months to 8 years whose diagnosis was presumed on clinical presentation and confirmed at surgery. Results. - The symptoms were intractable otorrhea, periauricular, cervical and parotid suppuration, which were present in two, 12, five and three cases, respectively. Two children had an abnormal eardrum and three an epidermic cyst in the external ear canal. Conclusion. - The diagnosis of a first branchial cleft anomaly must be considered in any patient with a history of recurrent periauricular swelling, a sinus located high in the neck or a mass in the external auditory canal.