First branchial cleft anomaly presenting as a recurrent post-auricular abscess.

Area of Science:

• Embryology
• Otolaryngology
• Surgical Pathology

Background:

• First branchial cleft anomalies are rare congenital malformations.
• They often present in the head and neck region, commonly as cysts or fistulas.
• Infection can obscure the underlying diagnosis, leading to misdiagnosis and inadequate treatment.

Observation:

• A patient presented multiple times with an infected post-auricular cyst.
• Initial treatment involved incision and drainage for presumed common infection.
• The cyst was ultimately identified as a first branchial cleft anomaly.

Findings:

• Embryological anomalies of the first branchial cleft are infrequently diagnosed.
• Delayed or incorrect diagnosis can result in treatment failure and surgical complications.
• Recognition is crucial for appropriate management and preventing recurrence.

Implications:

• Highlights the importance of considering rare embryological causes for seemingly common presentations.
• Emphasizes the need for thorough evaluation to avoid misdiagnosis of branchial cleft anomalies.
• Proper diagnosis and management are essential to prevent complications and ensure successful surgical outcomes.