First Branchial Cleft Sinus

Khalid Al Aboud, MD, Khalid Al Hawsawi, MD, V. Ramesh, MD, Daifullah Al Aboud, MD, Ahmed Al Githami, MD


Skinmed. 2003;2(1) 

In This Article


An 11-year-old boy presented with a crusted lesion on the right postauricular region of 5 years' duration. The condition began as a swelling when he was 1 year old and had ruptured. The lesion failed to heal completely. There was recurrent discharge and periods of quiescence, and at age 3 years he presented to a hospital. The doctors had simply diagnosed the condition as "periauricular sinus." Radiologic examination of the mastoids had revealed that both appeared normal. A computed tomographic scan of the parotid gland region revealed identical parotid glands on either side. A sinogram was performed revealing a 0.5-cm long sinus tract with a width of 2 mm. Following routine blood tests and urinalysis, which were normal, surgery was advised. The sinus was excised by the surgeon and sent for histopathology, which reported an inflamed sinus with foreign body granulomatous reaction. The child was discharged and the lesion had apparently healed. However, some months later the father noticed a small moist papule in the same region which very gradually increased, resulting in a lesion similar to the original lesion. Occasional discharge had formed a circular, thick crust in that area when he was referred to us for advice.