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[Study on CT features of congenital branchial cleft anomaly in children]
Yilong Zhou1, Wei Chen2, Rong Xu3
1Department of Children Otorhinolaryngology，Shenzhen Hospital，Southern Medical University，Shenzhen，518000，China.
Insights
This study highlights key CT imaging features of congenital branchial cleft anomalies in children. Accurate CT analysis aids in diagnosing first and second branchial cleft anomalies and piriform sinus fistulas, improving surgical planning.
Area of Science:
- Pediatric Radiology
- Head and Neck Imaging
- Congenital Anomalies
Background:
- Congenital branchial cleft anomalies are relatively common in children.
- Accurate diagnosis is crucial for effective surgical intervention and to prevent misdiagnosis.
- Computed Tomography (CT) plays a vital role in characterizing these anomalies.
Purpose of the Study:
- To summarize and elucidate the characteristic CT findings of congenital branchial cleft anomalies in pediatric patients.
- To enhance diagnostic accuracy and guide surgical strategies for these conditions.
- To differentiate between first branchial cleft anomaly, second branchial cleft anomaly, and congenital piriform sinus fistula using CT.
Main Methods:
- Retrospective analysis of CT imaging data from 323 pediatric patients.
- Patients diagnosed with congenital first branchial cleft anomaly, second branchial cleft anomaly, or congenital piriform sinus fistula.
- Confirmation of diagnoses through surgery and post-operative histopathology.
Main Results:
- Congenital first branchial cleft anomaly (36.8%) often involves the external auditory canal and parotid gland; CT positive rate was 87.4%.
- Congenital second branchial cleft anomaly (17.6%) typically relates to the submandibular gland; CT positive rate was 84.2%.
- Congenital piriform sinus fistula (45.5%) is frequently associated with the thyroid gland; CT positive rate was 89.1%.
Conclusions:
- CT findings for congenital first branchial cleft anomaly include lesions near the external auditory canal and parotid gland.
- CT features of congenital second branchial cleft anomaly point to lesions in the ipsilateral submandibular gland.
- Congenital piriform sinus fistula on CT is characterized by a focus on the dorsal side of the thyroid gland's lateral lobe.
Abstract:
Objective:To summarize the CT features of congenital branchial cleft anomaly in children, to reduce misdiagnosis and improve surgical strategy. Methods:This study enrolled 323 pediatric patients with congenital first branchial cleft anomaly, congenital second branchial cleft anomaly and congenital piriform sinus fistula confirmed by surgery and post-operative histopathology, who was admitted to Shanghai Children's hospital from August 2014 to January 2021., CT imaging data were retrospectively analyzed. Results:A total of 323 children with congenital branchial cleft deformity were included. There were 145 males and 178 females, aged from 22 days to 15 years. 119（119/323, 36.8%） cases were diagnosed as congenital first branchial cleft anomaly. Among them, 96 cases（96/119, 80.67%） were related to the wall of external auditory canal, and 89 cases（89/119, 74.78%） were related to parotid gland. The positive rate of CT examination was 87.4%（104/119）. 57 cases（57 / 323, 17.6%） had congenital second branchial cleft anomaly. Among them, 46 cases（46/57, 80.7%） were related to submandibular gland. The positive rate of CT examination was 84.2%（48/57）. 147 cases（147/323, 45.5%） had congenital piriform sinus fistula, in which 129 cases（129/147, 87.8%） were related to thyroid. The positive rate of CT was 89.1%（131/147）. Conclusion:The CT findings of congenital first branchial cleft anomaly are characterized by lesions in the inferior and/or posterior wall of ipsilateral external auditory canal and parotid gland. The CT features of congenital second branchial cleft anomaly are that the lesion is located on the ipsilateral submandibular gland （posterior and medial）. The CT features of congenital piriform sinus fistula are that the focus is located on the dorsal side of the upper pole of the lateral lobe of the thyroid gland.
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