0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Note |

Congenital Pharyngo-oto-cutaneous Fistula:  Surgical Management of an Unusual Anomaly of the First Branchial Apparatus

Jennifer B. Do, MD; Barry M. Rasgon, MD; Joshua A. Gottschall, MD
Arch Otolaryngol Head Neck Surg. 2012;138(2):189-192. doi:10.1001/archoto.2011.1072.
Text Size: A A A
Published online

Extract

First branchial anomalies embody a small subset of congenital malformations of the head and neck. Classically, they are duplication abnormalities of the external auditory canal (EAC) and can involve the middle ear and parotid gland. Herein, we describe a 5-year-old girl with unilateral microtia, autism, and Cayler cardiofacial syndrome (asymmetric crying facies and congenital heart disease). She also had a congenital pharyngo-oto-cutaneous fistula resulting in high-volume otorrhea of saliva and formula. We present our experience with surgical correction of this unique condition. To our knowledge, this is the first reported case of a congenital pharyngo-oto-cutaneous fistula involving a derangement of all 3 germ layers of the first branchial apparatus.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. The malformation of the right pinna included an accessory auricle (arrow) composed of cartilage that appeared to be a remnant tragus. Lateral to the canal is a soft-tissue bulge (asterisk), which, when reflected anteriorly, reveals a fully mucosalized fistulous tract.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Coronal computed tomographic image of the right temporal bone. The right external auditory canal (EAC) and middle ear spaces are opacified. There is an absence of the inferior wall of the EAC and floor of the middle ear, with ossifications in the expected region of the floor containing 2 unerupted teeth.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 3. A transoral view of the right lateral pharynx with an absent posterior pillar and tonsil replaced by aberrant lingual tissue. *Aberrant lingual tissue; †anterior pillar.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 4. Elevation of the fistulous tract, with a free-floating tooth extracted from the tympanic ring remnant. *Tooth; patient orientation: †anterior, ‡posterior, §superior, and ∥inferior.

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();