Branchial arch anomalies: Recurrence, malignant degeneration and operative complications.
OBJECTIVE
Branchial arch anomalies (BAA) represent one of the commonest pediatric neck masses, but large case series are lacking with none specifically examining risk of recurrence, surgical complications, and malignancy.


STUDY DESIGN
Retrospective study of patients with BAA at Mayo Clinic from 1/1/1976-7/29/2011.


METHODS
Features studied include age, gender, location, BAA type, symptoms, recurrence, preoperative management, extent of surgery, pathology as well as presence of tracts. Associations with tracts, operative complications, and recurrence were evaluated.


RESULTS
421 subjects underwent BAA excision during the study period at our institution. Subjects with tracts were symptomatic earlier. Four cases (mean age 60.3 years) of malignancy were identified. Among the 358 (non-remenant) BAA patients with no previous excision, 3.6% recurred at a mean of 47.1 months following surgery. Patients who underwent incision and drainage prior to BAA excision were 3.4 times more likely to recur. 2% experienced complications. Age, BAA type, preoperative imaging and extent of surgery did not affect recurrence or complication rates.


CONCLUSION
Patients with history of preoperative incision and drainage should be followed closely for recurrence the first four years. Early BAA excision is not associated with higher complication rate. Extent of resection should be determined by gross margins of BAA. Malignant degeneration was not seen in children. Malignancies have been seen in older patients (over 45 years) diagnosed with BAA, and a thorough work-up is important for correct diagnosis.
['Al-Mufarrej|Faisal|F|', 'Stoddard|David|D|', 'Bite|Uldis|U|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001934:Branchial Region D002648:Child D002675:Child, Preschool D019465:Craniofacial Abnormalities D005260:Female D006801:Humans D007223:Infant D008297:Male D008875:Middle Aged D010608:Pharyngeal Diseases D011183:Postoperative Complications D012008:Recurrence D012189:Retrospective Studies D016019:Survival Analysis D055815:Young Adult
Branchial arch Recurrence Malignancy Complications