Abstract
We report a case of a fistula of the first branchial cleft. A 7-year-old female complained of swelling and redness at the right angle of the mandible. She had a skin fistula with redness at the anterior and above the right angle of the mandible. MRI imaging revealed the tract of the fistula. The fistulous tract extended from the external cutaneous opening anterior and above the right angle of the mandible, through the parotid gland, to the cartilaginous external auditory canal. We excised the fistula, utilizing superficial lobectomy of the parotid gland after identification of the main trunk of the facial nerve. The fistulous tract was located in the cartilaginous external auditory canal from the right angle of the mandible, traveling outside the facial nerve, and ending blindly in the cartilaginous external auditory canal. Facial palsy was not observed after surgery. Microscopic examination of the fistula showed squamous epithelium and skin adnexa including hair. It is important to recognize that there are diverse positional relationships between fistulous tracts and the facial nerve.
