Evaluation of Surgical Outcomes of First Branchial Arch Anomalies: A Case Series

First Branchial Arch Anomalies (FBAA) are rare congenital conditions that present as cysts, fistulas, or abscesses. Failure to suspect the nature of the presenting lesion often leads to inadequate treatment and compromises the outcomes of definitive procedures undertaken later. In the present case series, eight patients with FBAA were identified (4 males and 4 females) with an average age of 29.5 years at presentation. Six of them had undergone prior procedures, including incision and drainage or excision. All patients underwent excision through a parotidectomy approach. Four patients experienced recurrences within a median period of 17 months post-surgery. Notably, three of the recurrences occurred in patients who had prior attempts at excision rather than merely incision and drainage. A high degree of suspicion in young individuals with cystic lesions in the parotid space, imaging to delineate the extent of the lesion, and an attempt at complete excision are key factors in successfully treating these conditions. Long-term follow-up is required to ensure the adequacy of the treatment strategy.