A 6-year-old girl has recurrent episodes of painful swelling of the right parotid region, each settling with antibiotics. On examination there is a small pit near the junction of the cartilaginous and bony external auditory canal that intermittently discharges clear fluid. Which anomaly best explains these findings?

• A Second branchial cleft fistula
• B Preauricular sinus
• C First branchial cleft anomaly, Work type II ✓
• D Thyroglossal duct remnant

Explanation

A tract communicating with the skin over the parotid region or angle of the mandible and opening into the external auditory canal defines a Work type II first branchial cleft anomaly. Recurrent parotid-region infections refractory to antibiotics are typical. A second branchial cleft fistula opens along the anterior border of the lower third of the sternocleidomastoid and drains into the tonsillar fossa. A preauricular sinus lies anterior to the helix and does not connect to the ear canal.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.