Two Cases of First Branchial Cleft Fistula

Abstract

We report on two cases of a fistula of the first branchial cleft. A 15-year-old female complained of swelling and tenderness of the temporal, postauricular and parotid gland regions. A large abscess revealed on a CT scan was incised and drained immediately. After the patient had left the hospital, we identified secretion from the external ear canal following pressure to the postauricular region, prompting us to consider the existence of a fistula of the first branchial cleft, opening onto the canal. We extracted the fistula located in the temporal and postauricular region and extending to the parotid gland deep lobe, after identification of the main trunk of the facial nerve. A 5-year-old male complained of swelling and tenderness of the parotid gland region. As the formation of the abscess recurred repeatedly, he underwent surgery. The fistula was located in the parotid gland superficial lobe and had adhered firmly to the cartilage of the external ear canal. After identification of facial nerve we extracted the fistula. After surgery, neither facial nerve palsy nor recurrence has been identified in either case.