Second branchial arch anomaly: case series of two

Abstract

Branchial apparatus develop between the 3^rd and 7^th weeks of embryonic life. There are 5 mesodermal arches separated by invaginations of ectoderm and endoderm. During development the second arch grows caudally to cover the third and fourth arches and the second, third, and fourth pharyngeal clefts eventually fusing with the lower neck. The enclosed II, III, and IV clefts are called as the cervical sinus. If this process does not occur for some reason then it gives rise to branchial cyst, sinus or fistula. We are presenting two cases of second branchial arch anomaly. In first case there was bilateral branchial fistula with right side fistula associated with branchial cyst. In second case there was unilateral right side branchial fistula. We operated both the cases by giving step ladder incision. In second case we find fistulous track opening in the tonsillar bed. Both the patients recovered well with no recurrence since 1 year. Brachial cleft cyst is a common cause of soft tissue swelling in the neck of a young adult. They generally occur unilaterally and are typically seen in the lateral aspect of the neck. It is clinically apparent in late childhood or early adulthood. In older adults with this presentation, it is important to exclude metastatic lymphadenopathy, lymphoma or tuberculosis.