{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:33:32Z","timestamp":1791930812616,"version":"4.3.4"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,8,22]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>First branchial cleft anomalies are quite rare, and the majority of them are found in and around the ear canal, mostly superficial to the facial nerve. Very rarely, the anomalous tract of the first branchial cleft can go deeper to the facial nerve, necessitating a meticulous and extensive surgery. A 21-year-old student presented with slowly increasing cystic swelling in the infra-auricular region. Findings of the magnetic resonance imaging were consistent with the first branchial cleft cyst, which also exhibited a deeper extent of the lesion into the parapharyngeal space. The entire tract was excised along with the superficial parotidectomy by an open approach. In addition to illustrating the presentation and management of this peculiar case, the present report also reviews the latest literature around their management.<\/jats:p>","DOI":"10.1136\/bcr-2021-244842","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T12:46:14Z","timestamp":1629981974000},"page":"e244842","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["First branchial cleft anomaly extending to parapharyngeal space"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-7393","authenticated-orcid":false,"given":"K","family":"Devaraja","sequence":"first","affiliation":[{"name":"Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka - 576104, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishwapriya Mahadev","family":"Godkhindi","sequence":"additional","affiliation":[{"name":"Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka - 576104, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay M","family":"Bhandarkar","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka - 576104, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"2025082712204840000_14.8.e244842.1","doi-asserted-by":"crossref","first-page":"2593","DOI":"10.1007\/s00405-020-06551-1","article-title":"Branchial cleft anomalies: hybrid \"Branchial Inclusion\" theory","volume":"278","author":"Pupi\u0107-Bakra\u010d","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2025082712204840000_14.8.e244842.2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3892\/etm.2017.4511","article-title":"First branchial cleft anomalies in children: experience with 30 cases","volume":"14","author":"Li","year":"2017","journal-title":"Exp Ther Med"},{"key":"2025082712204840000_14.8.e244842.3","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197209000-00001"},{"key":"2025082712204840000_14.8.e244842.4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-238727","article-title":"Management of a prestyloid parapharyngeal first branchial cleft cyst from puncture to surgical excision and how a routine procedure can turn into an emergency","volume":"14","author":"Fiedler","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082712204840000_14.8.e244842.5","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40463-020-00426-5","article-title":"Unusual presentation of a first branchial cleft cyst associated with an abnormal bony canal -A case report","volume":"49","author":"Fanous","year":"2020","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2025082712204840000_14.8.e244842.6","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1007\/s00405-012-2287-x","article-title":"First branchial cleft anomalies: presentation, variability and safe surgical management","volume":"270","author":"Magdy","year":"2013","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2025082712204840000_14.8.e244842.7","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1007\/s12070-013-0641-y","article-title":"First branchial cleft anomalies: avoiding the misdiagnosis","volume":"65","author":"Kumar","year":"2013","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"2025082712204840000_14.8.e244842.8","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/s12070-019-01634-w","article-title":"Importance and impact of appropriate radiology in the management of branchial cleft anomalies","volume":"71","author":"Mehmi","year":"2019","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"2025082712204840000_14.8.e244842.9","doi-asserted-by":"crossref","first-page":"rjaa291","DOI":"10.1093\/jscr\/rjaa291","article-title":"An occult case of the first branchial cleft anomaly","volume":"2020","author":"Muranishi","year":"2020","journal-title":"J Surg Case Rep"},{"key":"2025082712204840000_14.8.e244842.10","first-page":"1945998211000448","article-title":"Sclerotherapy for benign cystic lesions of the head and neck: systematic review of 474 cases","volume":"1945998211000448","author":"Talmor","year":"2021","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2025082712204840000_14.8.e244842.11","doi-asserted-by":"crossref","first-page":"225","DOI":"10.4103\/JMU.JMU_111_19","article-title":"Ultrasound-guided-fine-needle aspiration drainage and percutaneous ethanol injection for benign neck cysts","volume":"28","author":"Liao","year":"2020","journal-title":"J Med Ultrasound"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:20:54Z","timestamp":1756322454000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,26]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bcr-2021-244842"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244842","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}