Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series

Figure 3

Case  3. (a)(1–4) Preoperative CT scans. White arrow depicts the right-sided lesion. (a)(1-2) Representative axial images revealing a well-defined right neck cyst (arrow) located posterior and deep to the parotid gland, with no clear connection to the skin. (a)(3-4) The extent of the right mandibular defect containing the cyst (arrow). (b) Identification of the tract extending deep to the facial nerve. In the inferior quadrant of the picture, a forcep is stenting the tract open as the facial nerve is being retracted. (FN: facial nerve; T: BCA tract). (c) Isolated tract after separating it from the facial nerve. A clamp is on the tract while the facial nerve is being retracted. (FN: facial nerve; T: BCA tract). (d) Tract extending medially entering the angle of the mandible. A clamp is on the tract (FN: facial nerve; M: mandible).

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