The Treatment for Type II First Branchial Cleft Anomalies with Abnormalities Lateral to the Tympanic Membrane.

OBJECTIVE:The present study aimed to introduce the surgical method for addressing type II first branchial cleft anomalies (FBCAs) in patients with visible abnormalities lateral to the tympanic membrane.DESIGN:Retrospective analysis.SETTING:Beijing Children's Hospital of Capital Medical University from January 2016 to January 2020.METHOD:We performed a retrospective analysis of data from patients with type II FBCAs with visible abnormalities lateral to the tympanic membrane. All patients underwent magnetic resonance imaging, (MRI), computed tomography (CT), and otoscopy examinations before surgery. Data regarding the patient's age, location of the opening, side affected, MRI/CT results, otoscopy findings, the relationship between the lesion and the external auditory canal (EAC), complications, and surgical procedure were recorded.RESULTS:15 patients with type II FBCAs (Work's classification) were included in our study. There were 3 different types of visible abnormalities lateral to the tympanic membrane: white masses (Type A), a fibrous band between the tympanic membrane and the EAC floor (Type B), and defects in the inferior wall of the EAC (Type C). Types A and C demonstrated internal fistulas of the FBCA. The roots of the FBCA in all 3 types were deep. Endoscopy was required for complete exposure of the fistula, especially for Types A and C.CONCLUSION:Some type II FBCAs patients had visible abnormalities lateral to the tympanic membrane. Otoscope was recommended for routine examination. For these kinds of patients, combined endoscopy during surgery was helpful for reducing the recurrence rate.LEVEL OF EVIDENCE:Level 3.