[Anomalies of the first branchial cleft - a review].

BACKGROUND: Fistulas, sinus or cysts which trace back to anomalies of the first branchial cleft are seldom compared to lateral neck cysts and fistulas. For their accurate diagnosis and safe treatment special embryological and anatomical knowledge is necessary.
MATERIAL AND METHODS: Embryology, anatomy, diagnosis and therapy are described and explained by 2 case studies in context to the current literature. RESULTS AND
CONCLUSION: Sonography and contrast-enhanced radiological methods represent the fundamental pillar of the diagnosis. Therapeutically, the complete extirpation is the first choice. Surgeries on children, patients with extended fistulas and special cases of fistula routes require particular carefulness. In certain cases with pronounced findings and low levels of symptoms a "wait-and-see" strategy can be justified. Surgically, protection of the facial nerve and prevention of recurrences are the greatest challenge. © Georg Thieme Verlag KG Stuttgart · New York.