Cervico-auricular Fistulae; a Review of Published Cases with a Report.

Congenital anomalies of the first branchial cleft are rare. Approximately 32 cases of cervicoauricular fistulae have been reported in the past hundred years: this includes the writer's own case in this review. The majority of sinuses and fistulae derived from the lateral cervical vestiges are concerned with the second pharyngeal pouch and its corresponding cleft. Auricular and pre-auricular fistulae are not excessively rare, but cervico-auricular fistulae are still infrequently recorded. In some cases reported as cervico-auricular fistulae, there is little doubt from the description that these are auricular or preauricular fistulae. Harding (1890) and Konig (1896) both recorded cases, but it was not until 1908 that Flint published a well-documented case report on this condition. Frazer (1923) postulated defects of closure of the first branchial cleft, though up to that time he thought that none had been reported. He stated that, 'If a cyst of such a vestige were present it would lie below the tube, behind (at any rate in part) the tensor palati and in front of the carotid and stylopharyngeus and if by any chance it opened in to the pharynx it would do so through the sinus of Morgagni.' In the following review only those cases that are well documented have been considered.