A child has a recurrent infected swelling and a small pit just below the earlobe, close to the angle of the mandible, with intermittent discharge. During infection, the swelling communicates with the external auditory canal. This anomaly arises from failure of fusion of which structures?

• A Second branchial cleft between the hyoid and third arches
• B First branchial cleft between the mandibular and hyoid arches ✓
• C Thyroglossal duct remnants
• D Preauricular sinus of the hillocks of His

Explanation

This is a first branchial cleft anomaly, Work type II, presenting as a sinus or cyst near the earlobe or angle of the mandible that may communicate with the external auditory canal. It results from incomplete obliteration of the first branchial cleft between the mandibular and hyoid arches. Second cleft anomalies open along the anterior border of sternocleidomastoid and drain to the tonsillar fossa, which distinguishes them clearly.

Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.