BRANCHIAL ANOMALIES - A REVIEW OF 52 CASES

Fifty-two patients with branchial anomalies (BA) treated at the Childr en's National Medical Center between 1983 and 1993 were reviewed to de termine the incidence of different types of anomalies and to analyze t he authors' method of diagnosis and management, First BA was seen in 2 5%, second in 40%, third in 8%, and fourth in 2%. In 25%, the origin o f the anomaly was undetermined. Our incidence of first BA was signific antly higher than the incidence reported in other series. Of the anoma lies, sinuses were more common than cysts or fistulae. Sinuses tend to present at an earlier age than cysts, which take time to enlarge and present clinically. Repeated incision and drainage and incomplete exci sions were frequently seen with first, third, and fourth anomalies due to misdiagnosis. Recent trend has been to utilize radiographic studie s more frequently, and they have been found to be helpful in guiding s urgical therapy, particularly with the more complicated cases.