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Sinusoidal Sources

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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

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Collaural Sinus: A Case Report.

A Z Huq¹, S R Parvez, H R Talukder

¹Dr AHM Zahurul Huq, Professor Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;

Mymensingh Medical Journal : MMJ

|January 5, 2021

Summary

First branchial cleft anomalies, a rare embryological defect, can present as persistent neck masses. This case highlights a collaural sinus, a specific type of first branchial cleft anomaly, diagnosed in an adult woman.

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Area of Science:

Otolaryngology
Embryology
Surgical Pathology

Background:

First branchial cleft anomalies constitute 8-10% of all branchial cleft defects and approximately 17% of pediatric cervical masses.
While generally benign, these anomalies can lead to morbidity through secondary infections and treatment complications.

Observation:

A 30-year-old female presented with a 20-year history of a discharging sinus in the floor of the right external auditory canal and an upper neck swelling.
Physical examination revealed a discharging sinus in the right external auditory canal (EAC) and a cystic neck mass; compression of the mass produced cheesy discharge from the EAC.
MRI demonstrated a cystic lesion in the right infra-auricular region with a tract extending to the EAC.

Findings:

Histopathology confirmed a cyst lined by stratified squamous epithelium with a fibrocollagenous wall containing mucous glands and significant lymphocytic infiltration.
The findings are consistent with a collaural sinus, a rare congenital malformation involving the first branchial cleft.

Implications:

This case underscores the importance of considering rare congenital anomalies like collaural sinus in the differential diagnosis of chronic ear discharge and neck masses.
Accurate diagnosis through imaging and histopathology is crucial for appropriate management and to prevent complications associated with first branchial cleft anomalies.