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Surgery E.N.T. ba5c4426

Which of the following statements about branchial cleft anomalies is true?

A
A fistula that lies between the external auditory canal and the submandibular region originates from the second branchial cleft
B
The course of the first branchial cleft fistula is through the bifurcation of the carotid artery
C
Injury to the hypoglossal nerve may occur during excision of a second branchial cleft fistula
D
The internal opening of the second branchial cleft fistula is usually found in the maxillary sinus
High-Yield Explanation
Branchial cleft cysts, sinuses, and fistulas are remnants of the first and second branchial pouches. The internal opening of the first is the external auditory canal; for the second, it is the posterolateral pharynx below the tonsillar fossa. The facial nerve may be injured during dissection of the first fistula. The second fistula passes between the carotid bifurcation and adjacent to the hypoglossal nerve. In childhood most branchial cleft anomalies present as a painless nodule along the lateral border of the sternocleidomastoid muscle. In adults, superinfection of the cyst or fistulous drainage via an orifice in the supraclavicular region may occur. Treatment is surgical excision.

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