First branchial cleft cyst presenting as a mass within the external auditory canal

Area of Science:

• Otolaryngology
• Developmental Biology
• Surgical Pathology

Background:

• External auditory canal (EAC) cysts are uncommon.
• First branchial cleft anomalies can present with diverse head and neck manifestations.
• Understanding the etiology of EAC lesions is crucial for diagnosis and management.

Observation:

• A unique case of a serous cyst arising within the external auditory canal is presented.
• The cyst's histological characteristics and potential origin from first branchial cleft remnants were investigated.
• Clinical presentation and diagnostic imaging were utilized to characterize the lesion.

Findings:

• The reported serous cyst in the EAC is hypothesized to be the first documented instance in medical literature.
• A possible etiological link between this cyst and first branchial cleft cyst is discussed.
• Surgical marsupialization of the cyst resulted in no recurrence over a two-year follow-up period.

Implications:

• This case expands the known spectrum of external auditory canal pathologies.
• It highlights the importance of considering branchial cleft anomalies in the differential diagnosis of EAC cysts.
• Successful marsupialization suggests a viable and conservative surgical approach for similar rare lesions.