FIRST BRANCHIAL CLEFT SINUSES - AN ANALYSIS OF CURRENT MANAGEMENT STRATEGIES AND TREATMENT OUTCOMES

First branchial cleft sinuses account for less than 1% of all branchia l cleft anomalies. A thorough understanding of the embryology and deve lopmental anatomy is essential for successful management. Nine cases o f first branchial cleft sinuses treated at The Hospital for Sick Child ren by the Department of Otolaryngology between 1984 and 1990 were rev iewed. A large proportion of these lesions were initially misdiagnosed despite significant symptomatology. This resulted in a high rate of i nfectious complications. Early diagnosis, prompt control of infection, and early surgical excision are recommended. Current methods of diagn osis and treatment are discussed along with techniques for facial nerv e preservation.