On the basis of these characteristics, we classified the anomaly as a type I FBCA. The most frequent clinical feature of a type I FBCA is ear discharge or recurrent periauricular swelling.
Atypical variants of FBCA exist, and various presentations make diagnosis and treatment difficult.
(4,6) The clinicoradiographic differential diagnosis of FBCAs includes benign lymphoepithelial cysts, venolymphatic malformations, primary parotid neoplasms, and suppurative adenopathy or abscess.
A preliminary diagnosis of a first branchial cleft anomaly (FBCA) was made, and a temporal bone computed tomography (CT) study was obtained to determine the extent of the lesion and its relationship to the facial nerve (figure 3).