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Imaging features and therapeutic approaches for congenital branchial anomalies in 1668 pediatric cases
Xiaowei Chen1, Bo Yu1, Fei Qiu1
1Department of ENT and Head & Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Children And Adolescents' Health, And Diseases Binsheng Road 3333, Hangzhou, 310051, Zhejiang, China.
Insights
This study outlines imaging features of congenital branchial anomalies (CBA) in children. Optimized imaging protocols improve diagnosis and surgical planning for pediatric CBA, leading to better clinical outcomes.
Area of Science:
- Pediatric Radiology
- Head and Neck Surgery
- Congenital Anomalies
Background:
- Congenital branchial anomalies (CBA) are common in children.
- Accurate diagnosis and management are crucial for optimal outcomes.
Purpose of the Study:
- To summarize imaging features of pediatric CBA.
- To propose cohort-based diagnostic criteria and surgical strategies.
- To provide a reference for precise clinical management of pediatric CBA.
Main Methods:
- Retrospective analysis of 1,668 pediatric CBA cases.
- Data collected on demographics, lesion characteristics, imaging, and treatment.
- Evaluation of imaging features and treatment regimens.
Main Results:
- The cohort comprised 936 males and 732 females, median age 3.02 years.
- Left-sided lesions (83.2%) and infection histories (83.6%) were common.
- Recommended imaging protocols: ultrasound for fistulas/sinuses, US+MRI for first branchial anomalies, MSCT fistulography for second branchial cleft fistulas.
Conclusions:
- Optimized imaging protocols enhance diagnostic accuracy for pediatric CBA.
- Tailored imaging guidance improves surgical planning.
- Enhanced diagnostic and surgical strategies lead to improved clinical outcomes.
Purpose:
To summarize the imaging features of congenital branchial anomalies (CBA) in children based on a large single‑center cohort, propose cohort-based stratified diagnostic criteria and individualized surgical strategies, and provide a reference for the precise clinical management of pediatric CBA.
Methods:
A retrospective study analyzed 1,668 pediatric CBA at the Children's Hospital of Zhejiang University between January 2017 and December 2024. Data regarding gender, age, lesion laterality, infection history, lesion type, imaging features, and treatment regimens were summarized and evaluated.
Results:
The cohort included 936 males (56.1%) and 732 females (43.9%), with a median age of 3.02 years. Lesions were left-sided in 83.2% of cases, and 83.6% had infection histories. The diagnostic protocol proposed ultrasound as the preferred modality for pyriform sinus fistulas and sternoclavicular sinuses; ultrasound with magnetic resonance imaging for first branchial anomalies; and multislice computed tomography fistulography (MSCTF) for second branchial cleft fistulas. Post-surgical recurrence occurred in 57 cases (3.4%), The complication rate was 2.3%.
Conclusion:
Optimized imaging protocols can improve the diagnostic accuracy of pediatric CBA, guide surgical planning and enhance clinical outcomes.
