First branchial cleft anomalies

A series of nine cases of first branchial cleft anomalies treated at Children's Hospital of Michigan from 1970-1978 is presented. A review of the literature and analysis of these cases reveals that the accepted criteria for classification of these anomalies are confusing and inadequate as they preclude the proper classification of a number of these cases. The embryogenesis of these anomalies is discussed with attention given to their relationship to the facial nerve. A proper classification is suggested.