Journal articles: 'Branchial arch'

1

Cohen, M. Michael. "Branchial Arch Syndromes." Cleft Palate-Craniofacial Journal 32, no. 6 (1995): 524. http://dx.doi.org/10.1597/1545-1569(1995)032<0524:bas>2.3.co;2.

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Cohen, M. Michael. "Branchial Arch Syndromes." Cleft Palate-Craniofacial Journal 32, no. 6 (1995): 524. http://dx.doi.org/10.1597/1545-1569_1995_032_0524_bas_2.3.co_2.

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Alfi, David, Din Lam, and Jaime Gateno. "Branchial Arch Syndromes." Atlas of the Oral and Maxillofacial Surgery Clinics 22, no. 2 (2014): 167–73. http://dx.doi.org/10.1016/j.cxom.2014.04.003.

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Al-Mufarrej, Faisal M., David G. Stoddard, and Uldis Bite. "Branchial Arch Anomalies." Plastic and Reconstructive Surgery 130 (November 2012): 7. http://dx.doi.org/10.1097/01.prs.0000421704.82385.61.

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Thakur, Ashoka Nand, and Priyambada . "Branchial Sinus with Cyst - Two Case Reports with Review of Literature." International Journal of Research and Review 8, no. 11 (2021): 375–77. http://dx.doi.org/10.52403/ijrr.20211147.

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Branchial cleft anomalies are well described, with the second arch anomaly being the commonest. Remains of cervical sinus of His may persist as a branchial cyst. A branchial sinus is formed when 2nd branchial arch fails to meet the 5th pharyngeal arch. Peak age for presentation of branchial cysts is in the third decade and that of the congenital sinuses and fistulae is at birth. The association of a branchial cyst with branchial sinus is very rare. We are presenting two cases had branchial cyst along with branchial sinus. It was managed successfully with complete excision. Histopathological examination confirmed the association. Keywords: Branchial Sinus, Branchial cyst,

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Goswami, Jayanta Kumar, Abhijit Sarma, and Chandan Jyoti Saikia. "RARE BRANCHIAL ARCH ANOMALIES." Journal of Evidence Based Medicine and Healthcare 3, no. 19 (2016): 752–55. http://dx.doi.org/10.18410/jebmh/2016/171.

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Johnson, I. J. M., J. V. Soames, and J. P. Birchall. "Fourth branchial arch fistula." Journal of Laryngology & Otology 110, no. 4 (1996): 391–93. http://dx.doi.org/10.1017/s0022215100133730.

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AbstractA case is presented of a rare congenital anomaly of the fourth branchial arch, which presented as an abscess in the anterior triangle, related to a fistula communicating with the pyriform fossa. Histopathological examination showed the fistula to be associated with thyroid tissue supporting the hypothesis that the ventral wing of the fourth pouch contributes to the thyroid gland.

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Thomas, T., H. Kurihara, H. Yamagishi, et al. "A signaling cascade involving endothelin-1, dHAND and msx1 regulates development of neural-crest-derived branchial arch mesenchyme." Development 125, no. 16 (1998): 3005–14. http://dx.doi.org/10.1242/dev.125.16.3005.

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Numerous human syndromes are the result of abnormal cranial neural crest development. One group of such defects, referred to as CATCH-22 (cardiac defects, abnormal facies, thymic hypoplasia, cleft palate, hypocalcemia, associated with chromosome 22 microdeletion) syndrome, exhibit craniofacial and cardiac defects resulting from abnormal development of the third and fourth neural crest-derived branchial arches and branchial arch arteries. Mice harboring a null mutation of the endothelin-1 gene (Edn1), which is expressed in the epithelial layer of the branchial arches and encodes for the endothelin-1 (ET-1) signaling peptide, have a phenotype similar to CATCH-22 syndrome with aortic arch defects and craniofacial abnormalities. Here we show that the basic helix-loop-helix transcription factor, dHAND, is expressed in the mesenchyme underlying the branchial arch epithelium. Further, dHAND and the related gene, eHAND, are downregulated in the branchial and aortic arches of Edn1-null embryos. In mice homozygous null for the dHAND gene, the first and second arches are hypoplastic secondary to programmed cell death and the third and fourth arches fail to form. Molecular analysis revealed that most markers of the neural-crest-derived components of the branchial arch are expressed in dHAND-null embryos, suggesting normal migration of neural crest cells. However, expression of the homeobox gene, Msx1, was undetectable in the mesenchyme of dHAND-null branchial arches but unaffected in the limb bud, consistent with the separable regulatory elements of Msx1 previously described. Together, these data suggest a model in which epithelial secretion of ET-1 stimulates mesenchymal expression of dHAND, which regulates Msx1 expression in the growing, distal branchial arch. Complete disruption of this molecular pathway results in growth failure of the branchial arches from apoptosis, while partial disruption leads to defects of branchial arch derivatives, similar to those seen in CATCH-22 syndrome.

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Whitworth, I. H., S. K. Suvarna, R. G. Wight, and G. P. Walsh-Waring. "Fourth branchial arch anomaly: a rare incidental finding in an adult." Journal of Laryngology & Otology 107, no. 3 (1993): 238–39. http://dx.doi.org/10.1017/s002221510012273x.

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A rare finding of a fourth branchial arch anomaly discovered at laryngectomy is presented. Clinical and histological findings are documented. The incidence and presentation of fourth branchial arch anomalies is discussed.

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Hall, A. Brad, Shannon Hasara, and Phillip Coker. "Identification of a branchial cleft anomaly via handheld point-of-care ultrasound." Journal of Ultrasonography 22, no. 88 (2022): 67–69. http://dx.doi.org/10.15557/jou.2022.0012.

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Aim of the study: Branchial anomalies result from incomplete obliteration of the branchial arch structures during embryogenesis. Second branchial arch anomalies are commonly found on the lower third of the neck, with an opening at the anterior border of the sternocleidomastoid muscle, and may drain secretions or purulent material. This case demonstrates the use of handheld point-of-care ultrasound to aid in the diagnosis of a branchial anomaly. Case description: The patient presented with a “hole” in the neck with intermittent drainage from the site. A 2 mm defect in the skin was noted anterior to the sternocleidomastoid muscle. A handheld ultrasound system was used to identify a well-defined, hypoechoic, cyst-like structure. Given the history, physical findings, and point-of-care ultrasound imaging, the diagnosis of a second branchial cleft sinus was made. Conclusions: The use of point-of-care ultrasound and knowledge of the sonographic characteristics of these lesions can assist the physician in the diagnosis of branchial arch anomalies.

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Patoulias, Ioannis, Evangelia Rachmani, Konstantinos Farmakis, Vasileios Rafailidis, Maria Kalogirou, and Dimitrios Patoulias. "A Bilateral, Non-syndromic, Type III Second Branchial Arch Sinus in a Neonate: a Case Report." Acta Medica (Hradec Kralove, Czech Republic) 61, no. 1 (2018): 33–36. http://dx.doi.org/10.14712/18059694.2018.21.

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The incidence of a second branchial arch sinus accounts for 26–60% of all existing congenital malformations deriving from the branchial apparatus. They are most usually detected between 14 months and 7 years of age, while their incidence during neonatal period and infancy accounts for 0.06% of all cases. The aim of this case study is to emphasize three rare characteristic features: the manifestation during neonatal period, the bilateral localization and the ultrasonographic diagnostic documentation. A 25 days old girl was admitted by her parents due to the presence of mucoid excretion from two small openings found on the neck. These openings were found bilaterally, between the mid and lower third of the anterior border of sternocleidomastoid muscle. Diagnosis was confirmed via ultrasonography. The patient underwent elective surgery during early infancy and both branchial fistulas were excised. Patient’s postoperative course was uneventful. In conclusion: – in cases of a bilateral second branchial arch sinus, the branchio-oto-renal (BOR) or branchio-otic (BO) syndromes must be excluded; – ultrasound scan can be used for the thorough evaluation of the sinus anatomic course and the relationship with the adjacent anatomic structures; – rompt diagnosis and early therapeutic intervention, even during neonatal period, ensures an uneventful post-operation course.

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Remjasz, Agnieszka, Pedro Clarós, and Andrea Clarós. "Second branchial cleft fistula in a child with genetically confirmed branchio-oto-renal (BOR) syndrome." Polski Przegląd Otorynolaryngologiczny 8, no. 1 (2019): 60–66. http://dx.doi.org/10.5604/01.3001.0013.1137.

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Branchial cleft anomalies constitute 32% to 45% of all neck pathologies in the pediatric population. These disorders may be a part of a branchio-oto-renal syndrome (Melnick-Fraser syndrome), characterized by branchial arch abnormalities, preauricular pits, hearing impairment, and various types of renal anomalies. Usually, the treatment of a branchial fistula does not necessarily require extensive diagnostics. However, in patients with a congenital branchial cleft fistula associated with ear anomalies recognized during a physical examination, and history of hearing loss or similar findings in other relatives, the additional analysis should be carried out to eliminate the possibility of BOR syndrome. The aim of this study is to present a rare case of a male patient presenting complete second branchial cleft fistula, diagnosed as having BOR syndrome.

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Jiang, Feng Yan, and Mark Kruit. "Complete Second Arch Branchial Fistula." Radiology 294, no. 2 (2020): 245. http://dx.doi.org/10.1148/radiol.2019191356.

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Schroeder, James W., Nadia Mohyuddin, and John Maddalozzo. "Branchial Anomalies in the Pediatric Population." Otolaryngology–Head and Neck Surgery 137, no. 2 (2007): 289–95. http://dx.doi.org/10.1016/j.otohns.2007.03.009.

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OBJECTIVE: We sought to review the presentation, evaluation, and treatment of branchial anomalies in the pediatric population and to relate these findings to recurrences and complications. STUDY DESIGN AND SETTING: We conducted a retrospective study at a tertiary care pediatric hospital. PATIENTS: Ninety-seven pediatric patients who were treated for branchial anomalies over a 10-year period were reviewed. Patients were studied if they underwent surgical treatment for the branchial anomaly and had 1 year of postoperative follow-up; 67 children met criteria, and 74 anomalies were studied. RESULTS: Patients with cysts presented at a later age than did those with branchial anomaly fistulas or sinus branchial anomalies. 32% of branchial anomalies were previously infected. Of these, 71% had more than one preoperative infection. 18% of the BA were first arch derivatives, 69% were second arch derivatives and 7% were third arch derivatives. There were 22 branchial cysts, 31 branchial sinusies and 16 branchial fistulas. The preoperative and postoperative diagnoses differed in 17 cases. None of the excised specimens that contained a cystic lining recurred; all five recurrences had multiple preoperative infections. CONCLUSIONS: Recurrence rates are increased when there are multiple preoperative infections and when there is no epithelial lining identified in the specimen.

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15

Hallak, Bassel, Salim Bouayed, Crispin Leishman, and Kishore Sandu. "Residual Fistula of Fourth Branchial Arch Anomalies and Recurrent Left-Side Cervical Abscess: Clinical Case and Review of the Literature." Case Reports in Otolaryngology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/931279.

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Congenital fourth branchial arch anomalies are uncommon entities. Most of these anomalies are diagnosed in childhood. The majority of cases occur on the left side. The clinical presentation of these anomalies varies with age. A respiratory distress is the usual clinical presentation in neonates, cervical cutaneous fistulas in late childhood or acute suppurative thyroiditis. Multiples diagnostic options have been described with different modalities of treatment. The majority of cases of fourth branchial arch anomalies are described only in case reports. We report a clinical case of recurrent cervical abscess in a young woman due to a residual fistula of fourth branchial arch.

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16

Caton, A., A. Hacker, A. Naeem, et al. "The branchial arches and HGF are growth-promoting and chemoattractant for cranial motor axons." Development 127, no. 8 (2000): 1751–66. http://dx.doi.org/10.1242/dev.127.8.1751.

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During development, cranial motor neurons extend their axons along distinct pathways into the periphery. For example, branchiomotor axons extend dorsally to leave the hindbrain via large dorsal exit points. They then grow in association with sensory ganglia, to their targets, the muscles of the branchial arches. We have investigated the possibility that pathway tissues might secrete diffusible chemorepellents or chemoattractants that guide cranial motor axons, using co-cultures in collagen gels. We found that explants of dorsal neural tube or hindbrain roof plate chemorepelled cranial motor axons, while explants of cranial sensory ganglia were weakly chemoattractive. Explants of branchial arch mesenchyme were strongly growth-promoting and chemoattractive for cranial motor axons. Enhanced and oriented axon outgrowth was also elicited by beads loaded with Hepatocyte Growth Factor (HGF); antibodies to this protein largely blocked the outgrowth and orientation effects of the branchial arch on motor axons. HGF was expressed in the branchial arches, whilst Met, which encodes an HGF receptor, was expressed by subpopulations of cranial motor neurons. Mice with targetted disruptions of HGF or Met showed defects in the navigation of hypoglossal motor axons into the branchial region. Branchial arch tissue may thus act as a target-derived factor that guides motor axons during development. This influence is likely to be mediated partly by Hepatocyte Growth Factor, although a component of branchial arch-mediated growth promotion and chemoattraction was not blocked by anti-HGF antibodies.

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Sima, Natashya H., Jomy George, Ophelia D’Souza, and Poonam K. Saidha. "A rare case of co-existing branchial cyst and thyroglossal cyst." International Journal of Otorhinolaryngology and Head and Neck Surgery 7, no. 12 (2021): 1953. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20214696.

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Thyroglossal duct remnants and branchial arch anomalies are the most common congenital neck masses. These anomalies typically present in childhood or early adulthood as cysts, sinuses or cartilaginous remnants, but may rarely present in late adulthood. Although both thyroglossal duct remnants and branchial cysts may be encountered individually, these anomalies are rarely encountered together in the same individual. We report the third such case of co-existing branchial cyst and thyroglossal cyst occurring in the same individual with review of embryological development of thyroglossal duct cysts and second branchial arch anomalies.

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Sunil, Pawara, Faiyaz Ali Sayed, and Jadhav Sarojini. "A Case of Complete Second Arch Branchial Fistula in a 11-YearOld Child." International Journal of Pharmaceutical and Clinical Research 15, no. 4 (2023): 441–45. https://doi.org/10.5281/zenodo.12667498.

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Introduction: Branchial cleft anomalies are formed due to failure of embryonic structures to obliterate during development. Anomalies in the development of branchial clefts can lead to cysts, external sinuses, internal sinuses, and complete fistulas. The branchial fistula arising from each arch can be identified from the position of the internal and external openings. In majority of cases, the tracts end blindly, leading on to the formation of branchial sinuses. Patients with fistulae often present with mucoid drainage from a lateral neck opening that may become infected over time. Definitive management consists of complete surgical excision of the fistula tract. We report a rare case of complete second arch branchial fistula in a 11 year‑old child, which was successfully treated by excision. Case Scenario: A 11 years old male presented to Surgery OPD with, chief complaints of opening over right side of neck since childhood with intermittent discharge from the opening. Opening of size 0.1×0.1cm over right side neck at the skin over middle third of anterior border of sternocleidomastoid. Patient was investigated by Conventional X-ray Fistulogram. Patient was further investigated by MRI Fistulogram showing- second branchial cleft cyst with fistula. Treatment: Patient was operated by brachial fistulectomy by Elliptical skin incision taken around the opening, incision deepened, underlying tract identified and dissected from surrounding structures till just above the level of submandibular gland almost in the area around the tonsillar fossa, the tract ligated at the base and around 6 cm length of tract excised. Postoperatively, patient was kept under surveillance for recurrence. Conclusion: We reported a rare case of radiologically demonstrable complete second arch branchial fistulae, diagnosed by Fistulogram and treated by complete excision.

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Liu, Chengyu, Wei Liu, Jennifer Palie, Mei Fang Lu, Nigel A. Brown, and James F. Martin. "Pitx2cpatterns anterior myocardium and aortic arch vessels and is required for local cell movement into atrioventricular cushions." Development 129, no. 21 (2002): 5081–91. http://dx.doi.org/10.1242/dev.129.21.5081.

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Inactivation of the left-right asymmetry gene Pitx2 has been shown, in mice, to result in right isomerism with associated defects that are similar to that found in humans. We show that the Pitx2c isoform is expressed asymmetrically in a presumptive secondary heart field within the branchial arch and splanchnic mesoderm that contributes to the aortic sac and conotruncal myocardium. Pitx2c was expressed in left aortic sac mesothelium and in left splanchnic and branchial arch mesoderm near the junction of the aortic sac and branchial arch arteries. Mice with an isoform-specific deletion of Pitx2c had defects in asymmetric remodeling of the aortic arch vessels. Fatemapping studies using a Pitx2 cre recombinase knock-in allele showed that daughters ofPitx2-expressing cells populated the right and left ventricles,atrioventricular cushions and valves and pulmonary veins. In Pitx2mutant embryos, descendents of Pitx2-expressing cells failed to contribute to the atrioventricular cushions and valves and the pulmonary vein,resulting in abnormal morphogenesis of these structures. Our data provide functional evidence that the presumptive secondary heart field, derived from branchial arch and splanchnic mesoderm, patterns the forming outflow tract and reveal a role for Pitx2c in aortic arch remodeling. Moreover, our findings suggest that a major function of the Pitx2-mediated left right asymmetry pathway is to pattern the aortic arches, outflow tract and atrioventricular valves and cushions.

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Krishnan, Meenu, Anitha Kumari, and Ramani C. V. "Management of a recurrent third branchial arch fistula using combined endoscopic and open approach." International Journal of Otorhinolaryngology and Head and Neck Surgery 10, no. 1 (2024): 146–48. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20240078.

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Branchial cleft anomalies are rare, congenital lesions, that occur due to the maldevelopment of the branchial apparatus, during fetal maturation. Anomalies of the third and fourth arch contribute to a very small proportion of these. Most cases are detected in childhood, either as a cyst, sinus or fistula in the neck. Some of the common treatment approaches to third branchial cleft fistulas include endoscopic cauterization, open cervical fistulectomy and, in cases of recurrence, selective neck dissection. Here, we present a case of recurrent branchial fistula of the third arch, wherein we used a combined cervical and intraoral approach, conserving the thyroid cartilage, to achieve a complete excision of the fistula tract.

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Lee, Y. M., N. Osumi-Yamashita, Y. Ninomiya, C. K. Moon, U. Eriksson, and K. Eto. "Retinoic acid stage-dependently alters the migration pattern and identity of hindbrain neural crest cells." Development 121, no. 3 (1995): 825–37. http://dx.doi.org/10.1242/dev.121.3.825.

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This study investigates the migration patterns of cranial neural crest cells in retinoic acid (RA)-treated rat embryos using DiI labeling. Wistar-Imamichi rat embryos were treated at the early (9.0 days post coitum, d.p.c.) and late (9.5 d.p.c.) neural plate stages with all-trans RA (2 × 10(−7) M) for 6 hours and further cultured in an RA-free medium. RA exposure stage dependently induced two typical craniofacial abnormalities; that is, at 9.0 d.p.c. it reduced the size and shape of the first branchial arch to those of the second arch, whereas, in contrast, at 9.5 d.p.c. it induced fusion of the first and second branchial arches. Early-stage treatment induced an ectopic migration of the anterior hindbrain (rhombomeres (r) 1 and 2) crest cells; they ectopically distributed in the second branchial arch and acousticofacial ganglion, as well as in their original destination, i.e., the first arch and trigeminal ganglion. In contrast, late-stage treatment did not disturb the segmental migration pattern of hindbrain crest cells even though it induced the fused branchial arch (FBA); labeled crest cells from the anterior hindbrain populated the anterior half of the FBA and those from the preotic hindbrain (r3 and r4) occupied its posterior half. In control embryos, cellular retinoic acid binding protein I (CRABP I) was strongly expressed in the second branchial arch, r4 and r6, while weakly in the first arch and r1-3. CRABP I was upregulated by the early-stage treatment in the first branchial arch and related rhombomeres, while its expression was not correspondingly changed by the late-stage treatment. Moreover, whole-mount neurofilament staining showed that, in early-RA-treated embryos, the typical structure of the trigeminal ganglion vanished, whereas the late-stage-treated embryos showed the feature of the trigeminal ganglion to be conserved, although it fused with the acousticofacial ganglion. Thus, from the standpoints of morphology, cell lineages and molecular markers, it seems likely that RA alters the regional identity of the hindbrain crest cells, which may correspond to the transformation of the hindbrain identity in RA-treated mouse embryos (Marshall et al., Nature 360, 737–741, 1992).

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Pandurangam, Gayathri, D. Naga Jyothi, Asra Anjum, and S. Saritha. "Anatomical organization of aortic arch variation with embryological basis and clinical application." International Journal of Anatomy and Research 9, no. 1.3 (2021): 7901–4. http://dx.doi.org/10.16965/ijar.2021.105.

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Introduction: The variation in the aortic arch is well known and it has been demonstrated by number of researchers. Changes involved in the development of aortic arch system such as regression, retention or reappearance result in the variation in branching pattern of aortic arch. Variations of the branches of aortic arch are due to alteration of branchial arch arteries during embryonic period. The most common classical branching pattern of the aortic arch in humans comprises of three great vessels, which includes Brachiocephalic trunk, Left Common Carotid artery and Left Subclavian artery. Aim: The study is to determine the embryological basis correlating with clinical application and surgical procedures. Materials and Methods: A study was conducted in 50 formalin fixed cadaveric hearts, during a period of two years. In the routine dissection for 1st MBBS and also museum specimens we encountered 3variations in the branches of arch of aorta. Results: The variations in aortic arch branching pattern were observed in 4 cadaveric hearts (8%). Conclusion: The wide spectrum of variation in the human aortic arch and its branches offer valuable information to catheterize in endovascular surgery for diagnostic and surgical procedures in the thorax, head and neck regions. KEY WORDS: Aortic Arch (AA), Left Common Carotid (LCCA), Left Subclavian (LSA), Brachiocephalic Trunk (BCT), left vertebral artery(LVA).

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Mankekar, Gauri, Sadhana R. Nayak, M. V. Kirtane, and M. V. Ingle. "Fourth branchial arch fistula: a case report." Journal of Laryngology & Otology 107, no. 5 (1993): 458–59. http://dx.doi.org/10.1017/s0022215100123448.

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Schilling, T. F., T. Piotrowski, H. Grandel, et al. "Jaw and branchial arch mutants in zebrafish I: branchial arches." Development 123, no. 1 (1996): 329–44. http://dx.doi.org/10.1242/dev.123.1.329.

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Jaws and branchial arches together are a basic, segmented feature of the vertebrate head. Seven arches develop in the zebrafish embryo (Danio rerio), derived largely from neural crest cells that form the cartilaginous skeleton. In this and the following paper we describe the phenotypes of 109 arch mutants, focusing here on three classes that affect the posterior pharyngeal arches, including the hyoid and five gill-bearing arches. In lockjaw, the hyoid arch is strongly reduced and subsets of branchial arches do not develop. Mutants of a large second class, designated the flathead group, lack several adjacent branchial arches and their associated cartilages. Five alleles at the flathead locus all lead to larvae that lack arches 4–6. Among 34 other flathead group members complementation tests are incomplete, but at least six unique phenotypes can be distinguished. These all delete continuous stretches of adjacent branchial arches and unpaired cartilages in the ventral midline. Many show cell death in the midbrain, from which some neural crest precursors of the arches originate. lockjaw and a few mutants in the flathead group, including pistachio, affect both jaw cartilage and pigmentation, reflecting essential functions of these genes in at least two neural crest lineages. Mutants of a third class, including boxer, dackel and pincher, affect pectoral fins and axonal trajectories in the brain, as well as the arches. Their skeletal phenotypes suggest that they disrupt cartilage morphogenesis in all arches. Our results suggest that there are sets of genes that: (1) specify neural crest cells in groups of adjacent head segments, and (2) function in common genetic pathways in a variety of tissues including the brain, pectoral fins and pigment cells as well as pharyngeal arches.

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Holtestaul, T. A., S. L. Rooney, and M. A. Escobar. "Cervical chondrocutaneous branchial remnant: A rare second branchial arch anomaly." Journal of Pediatric Surgery Case Reports 64 (January 2021): 101739. http://dx.doi.org/10.1016/j.epsc.2020.101739.

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Grammatopoulos, G. A., E. Bell, L. Toole, A. Lumsden, and A. S. Tucker. "Homeotic transformation of branchial arch identity after Hoxa2 overexpression." Development 127, no. 24 (2000): 5355–65. http://dx.doi.org/10.1242/dev.127.24.5355.

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Overexpression of Hoxa2 in the chick first branchial arch leads to a transformation of first arch cartilages, such as Meckel's and the quadrate, into second arch elements, such as the tongue skeleton. These duplicated elements are fused to the original in a similar manner to that seen in the Hoxa2 knockout, where the reverse transformation of second to first arch morphology is observed. This confirms the role of Hoxa2 as a selector gene specifying second arch fate. When first arch neural crest alone is targeted, first arch elements are lost, but the Hoxa2-expressing crest is unable to develop into second arch elements. This is not due to Hoxa2 preventing differentiation of cartilages. Upregulation of a second arch marker in the first arch, and homeotic transformation of cartilage elements is only produced after global Hoxa2 overexpression in the crest and the surrounding tissue. Thus, although the neural crest appears to contain some patterning information, it needs to read cues from the environment to form a coordinated pattern. Hoxa2 appears to exert its effect during differentiation of the cartilage elements in the branchial arches, rather than during crest migration, implying that pattern is determined quite late in development.

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Madana, J., D. Yolmo, S. Gopalakrishnan, and S. K Saxena. "Complete congenital third branchial fistula with left-sided, recurrent, suppurative thyroiditis." Journal of Laryngology & Otology 124, no. 9 (2010): 1025–29. http://dx.doi.org/10.1017/s0022215110000034.

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AbstractObjective:We report an extremely rare case of a complete congenital third branchial arch fistula in a nine-year-old boy.Method:A case report and a review of the English literature concerning third branchial arch fistula of congenital origin are presented.Results:A nine-year-old boy presented with a history of a small opening in the middle third of the anterior neck since birth, with recurrent surrounding swelling. There was no history of surgical drainage or spontaneous rupture. Computed tomography with contrast injection into the external cervical opening revealed a patent tract from the neck skin to the base of the pyriform sinus. Complete excision of the tract up to the pyriform sinus with left hemithyroidectomy was performed. Follow up at 22 months showed no recurrence.Conclusion:To our knowledge, this case represents a very rare occurrence of the congenital variety of complete third branchial arch fistula at an unusual site. This case indicates that third branchial arch fistula can be complete, and may present in the anterior neck, an unusual site. In such cases, computed tomography fistulography and injection of dye into the pyriform sinus enables intra-operative delineation of the tract.

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Tiwari, Saurabh, Apoorva Kulkarni, Abhaya Gupta, and Paras Kothari. "Bilateral branchial arch anomaly: a rare case report." International Surgery Journal 7, no. 8 (2020): 2879. http://dx.doi.org/10.18203/2349-2902.isj20203280.

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Anomalies of branchial arches are uncommon anomalies of embryonic development and may present as cysts, sinus tracts, fistulae or cartilaginous remnants. They represent the embryological precursors of face, neck and pharynx and are the second most common congenital lesions of head and neck in children. Although pharyngeal apparatus (branchial) anomalies are frequently seen, bilateral cases are rare (only 2% to 3%). Our patient was a 3 months old child with a swelling on right side of neck and discharging sinus from left side since birth. Surgical excision of the right branchial cyst with its complete tract was done along with excision of the left branchial fistulous tract upto the tonsillar fossa. Post-operative course was uneventful and patient was discharged the next day.

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Patel, Jitendra P., Naimish R. Bhojak, and Jalpa N. Desai. "Variations in branching pattern of arch of aorta in Gujarat region." National Journal of Clinical Anatomy 05, no. 04 (2016): 185–90. http://dx.doi.org/10.1055/s-0039-3401612.

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Abstract Background and aim: Study of variation in branching pattern of arch of aorta is important for cardio vascular surgeons to avoid injury during procedures like angiography and stenting of aorta. These variations are frequently encountered during surgical procedures, as a developmental alteration in branchial arch during embryonic period. The aim of present study is to describe variation in branching pattern of arch of aorta belonging to Gujarati population and these results will be of significance for anatomists for relating it with embryological basis, cardiovascular surgeons and radiologists. Materials and metbods: Forty embalmed cadavers were observed for study of branching pattern of arch of aorta during period of four year in Department of Anatomy in Smt N.H.L.Municipal Medical College, Ahmedabad. Results: In the present study, normal branching pattern of the arch of aorta was found in 92.5% cases. In 2.5% cases only two vessels originated from the arch of aorta, one of them was common trunk for brachiocephalic trunk and left common carotid artery and the second trunk was left subclavian artery. In 5% of cases four vessels arose from arch of aorta, the left vertebral artery arose directly from aorta with normal branching pattern. Conclusion: Vascular invasive procedures are increasing since last decade. So knowledge of variation in branches of arch of aorta is essential for cardiologist, cardiovascnlar surgeon as well as for radiologist.

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Potvin, Éric, Laurent Beuret, Jean-François Cadrin-Girard, et al. "Cooperative Action of Multiple cis-Acting Elements Is Required for N-myc Expression in Branchial Arches: Specific Contribution of GATA3." Molecular and Cellular Biology 30, no. 22 (2010): 5348–63. http://dx.doi.org/10.1128/mcb.00353-09.

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ABSTRACT The precise expression of the N-myc proto-oncogene is essential for normal mammalian development, whereas altered N-myc gene regulation is known to be a determinant factor in tumor formation. Using transgenic mouse embryos, we show that N-myc sequences from kb −8.7 to kb +7.2 are sufficient to reproduce the N-myc embryonic expression profile in developing branchial arches and limb buds. These sequences encompass several regulatory elements dispersed throughout the N-myc locus, including an upstream limb bud enhancer, a downstream somite enhancer, a branchial arch enhancer in the second intron, and a negative regulatory element in the first intron. N-myc expression in the limb buds is under the dominant control of the limb bud enhancer. The expression in the branchial arches necessitates the interplay of three regulatory domains. The branchial arch enhancer cooperates with the somite enhancer region to prevent an inhibitory activity contained in the first intron. The characterization of the branchial arch enhancer has revealed a specific role of the transcription factor GATA3 in the regulation of N-myc expression. Together, these data demonstrate that correct N-myc developmental expression is achieved via cooperation of multiple positive and negative regulatory elements.

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Al-Ghadyan, Abdulrahman A., Gholam Q. Kazi, and Edward Cotlier. "Anophthalmos and First Branchial Arch Defects." Ophthalmic Paediatrics and Genetics 6, no. 3 (1985): 169–78. http://dx.doi.org/10.3109/13816818509087637.

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Behera, Sanjaya Kumar, Deepak Dalmia, and Ashay Amlekar. "Second branchial arch anomaly: case series of two." International Journal of Otorhinolaryngology and Head and Neck Surgery 3, no. 3 (2017): 742. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20173060.

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Branchial apparatus develop between the 3rd and 7th weeks of embryonic life. There are 5 mesodermal arches separated by invaginations of ectoderm and endoderm. During development the second arch grows caudally to cover the third and fourth arches and the second, third, and fourth pharyngeal clefts eventually fusing with the lower neck. The enclosed II, III, and IV clefts are called as the cervical sinus. If this process does not occur for some reason then it gives rise to branchial cyst, sinus or fistula. We are presenting two cases of second branchial arch anomaly. In first case there was bilateral branchial fistula with right side fistula associated with branchial cyst. In second case there was unilateral right side branchial fistula. We operated both the cases by giving step ladder incision. In second case we find fistulous track opening in the tonsillar bed. Both the patients recovered well with no recurrence since 1 year. Brachial cleft cyst is a common cause of soft tissue swelling in the neck of a young adult. They generally occur unilaterally and are typically seen in the lateral aspect of the neck. It is clinically apparent in late childhood or early adulthood. In older adults with this presentation, it is important to exclude metastatic lymphadenopathy, lymphoma or tuberculosis.

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Worley, George A., Archana Vats, Jonathan Harcourt, and David M. Albert. "Bilateral congenital cholesteatoma in branchio-oto-renal syndrome." Journal of Laryngology & Otology 113, no. 9 (1999): 841–43. http://dx.doi.org/10.1017/s0022215100145359.

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AbstractBranchio-oto-renal syndrome is a rare autosomal dominant condition characterized by hearing loss, branchial arch abnormalities and renal tract malformations. We present the first reported case of branchio-oto-renal syndrome associated with bilateral congenital cholesteatoma and ossicular chain abnormalities. The pathogenesis of this syndrome is described and the literature is reviewed.

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Decostere, Annemie, James F. Turnbull, Richard Ducatelle, and Freddy Haesebrouck. "Development of a Gill Perfusion Apparatus for Studying the Interaction of Fish Pathogens with Gill Tissue." Alternatives to Laboratory Animals 28, no. 1 (2000): 53–61. http://dx.doi.org/10.1177/026119290002800103.

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An isolated perfused gill preparation was developed for the study of the association of gill pathogens with the branchial tissue. The preparation consisted of an excised branchial arch from common carp ( Cyprinus carpio L., minimum weight 300g), perfused via the afferent branchial artery. Filtered and heparinised Cortland solution was used as the perfusion fluid and infused by means of a drip (3-litre bag). The average perfusion rate was 1.5ml/minute/arch/kg body weight. The outflowing perfusate was collected from a cannula in the efferent branchial artery. The individual gill arch was suspended in a circular organ chamber filled with Ringer solution, which was aerated and kept at a constant temperature of 20°C. Unperfused gill arches maintained in Ringer solution at the same temperature served as controls. Cortland solution proved to be a satisfactory perfusion fluid, maintaining the perfused gills in a healthy condition for at least 4 hours with no, or only slight, oedema after 90 minutes, and slight or moderate oedema after 4 hours. The unperfused gill displayed excessive necrosis and loss of architecture after 4 hours. The Cortland perfused gill apparatus could thus prove to be an alternative ex vivo model of particular use in the study of the early interaction of gill associated pathogens with the branchial tissue.

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Raj, Sagaya, Azeem Mohiyuddin, Kouser Mohammadi, Shuaib Merchant, Ravindra P. Deo, and Samdani Nawaz. "Selective Neck Dissection: A Novel Technique for Second Branchial Arch Anomalies." International Journal of Head and Neck Surgery 5, no. 2 (2014): 57–60. http://dx.doi.org/10.5005/jp-journals-10001-1182.

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ABSTRACT Introduction To propose an operation similar to selective neck dissection (levels II, III and IV) as a method of successful management of second arch branchial anomalies. Materials and methods We did a prospective study on patients with branchial arch anomalies from the years 2009 to 2013. They underwent minimal radiological workup. All of them underwent a novel surgical procedure similar to selective neck dissection (levels II, III, IV) that lead to excision of the tract. Patients were followed up for an average period of 2 years. Results We had seven patients which included two branchial sinus, three cysts and two fistulae. All of them were operated and the tract was identified and completely excised by the above approach. None of them had any complications or recurrence on follow-up. Conclusion Branchial arch anomalies are rare congenital problems posing a significant challenge to an ENT surgeon. Inadequate and inappropriate surgeries resulting in recurrences are quite common. Attempts to get either a sinogram or fistulogram are often a failure and cumbersome. Selective neck dissection from levels II to IV is a surgical maneuver which allows access to the involved anatomical segment of the neck. Thus, it is a structured and methodical approach that comprehensively leads to excision of the complete tract. It also reduces the chances of complications. Recurrences are rare with this technique. How to cite this article Merchant S, Mohiyuddin A, Deo RP, Raj S, Nawaz S, Mohammadi K. Selective Neck Dissection: A Novel Technique for Second Branchial Arch Anomalies. Int J Head Neck Surg 2014;5(2):57-60.

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Budhiraja, Virendra, Rakhi Rastogi, Vaishali Jain, Vishal Bankwar, and Shiv Raghuwanshi. "Anatomical Variations in the Branching Pattern of Human Aortic Arch: A Cadaveric Study from Central India." ISRN Anatomy 2013 (September 12, 2013): 1–5. http://dx.doi.org/10.5402/2013/828969.

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Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Knowledge of these variations is important during aortic instrumentation, thoracic, and neck surgeries. In the present study we observed these variations in fifty-two cadavers from Indian populations. In thirty-three (63.5%) cadavers, the aortic arch showed classical branching pattern which includes brachiocephalic trunk, left common carotid artery, and left subclavian artery. In nineteen (36.5%) cadavers it showed variations in the branching pattern, which include the two branches, namely, left subclavian artery and a common trunk in 19.2% cases, four branches, namely, brachiocephalic trunk, left common carotid artery, left vertebral artery, and left subclavian artery in 15.3% cases, and the three branches, namely, common trunk, left vertebral artery, and left subclavian artery in 1.9% cases.

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Kanzler, B., S. J. Kuschert, Y. H. Liu, and M. Mallo. "Hoxa-2 restricts the chondrogenic domain and inhibits bone formation during development of the branchial area." Development 125, no. 14 (1998): 2587–97. http://dx.doi.org/10.1242/dev.125.14.2587.

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In Hoxa-2(−/−)embryos, the normal skeletal elements of the second branchial arch are replaced by a duplicated set of first arch elements. We show here that Hoxa-2 directs proper skeletal formation in the second arch by preventing chondrogenesis and intramembranous ossification. In normal embryos, Hoxa-2 is expressed throughout the second arch mesenchyme, but is excluded from the chondrogenic condensations. In the absence of Hoxa-2, chondrogenesis is activated ectopically within the rostral Hoxa-2 expression domain to form the mutant set of cartilages. In Hoxa-2(−/−)embryos the Sox9 expression domain is shifted into the normal Hoxa-2 domain. Misexpression of Sox9 in this area produces a phenotype resembling that of the Hoxa-2 mutants. These results indicate that Hoxa-2 acts at early stages of the chondrogenic pathway, upstream of Sox9 induction. We also show that Hoxa-2 inhibits dermal bone formation when misexpressed in its precursors. Furthermore, molecular analyses indicate that Cbfa1 is upregulated in the second branchial arches of Hoxa-2 mutant embryos suggesting that prevention of Cbfa1 induction might mediate Hoxa-2 inhibition of dermal bone formation during normal second arch development. The implications of these results on the patterning of the branchial area are discussed.

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Vaughan, C., S. J. Prowse, and L. C. Knight. "Hairy polyp of the oropharynx in association with a first branchial arch sinus." Journal of Laryngology & Otology 126, no. 12 (2012): 1302–4. http://dx.doi.org/10.1017/s0022215112001752.

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AbstractObjectives:Hairy polyps are rare, congenital malformations of the oropharynx and nasopharynx. To date, approximately 145 cases have been reported. However, the histogenesis of these lesions remains unclear.Case report:We report the case of a 2-day-old neonate presenting with a hairy polyp attached to the left palate, who re-presented aged 16 months with a discharging first branchial arch sinus.Conclusion:We propose this case as supporting evidence for the theory that hairy polyps are a malformation of the first branchial arch system.

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Ostfeld, E. J., J. M. Wiesel, S. Rabinson, and L. Auslander. "Parapharyngeal (retrostyloid)—third branchial cleft cyst." Journal of Laryngology & Otology 105, no. 9 (1991): 790–92. http://dx.doi.org/10.1017/s0022215100117359.

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Prasad, Sampath Chandra, Arun Azeez, Nikhil Dinaker Thada, Pallavi Rao, Andrea Bacciu, and Kishore Chandra Prasad. "Branchial Anomalies: Diagnosis and Management." International Journal of Otolaryngology 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/237015.

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Objective. To find out the incidence of involvement of individual arches, anatomical types of lesions, the age and sex incidence, the site and side of predilection, the common clinical features, the common investigations, treatment, and complications of the different anomalies.Setting. Academic Department of Otolaryngology, Head and Neck Surgery.Design. A 10 year retrospective study.Participants. 30 patients with clinically proven branchial anomalies including patients with bilateral disease totaling 34 lesions.Main Outcome Measures. The demographical data, clinical features, type of branchial anomalies, and the management details were recorded and analyzed.Results and Observations. The mean age of presentation was 18.67 years. Male to female sex ratio was 1.27 : 1 with a male preponderance. Of the 34 lesions, maximum incidence was of second arch anomalies (50%) followed by first arch. We had two cases each of third and fourth arch anomalies. Only 1 (3.3%) patients of the 30 presented with lesion at birth. The most common pathological type of lesions was fistula (58.82%) followed by cyst. 41.18% of the lesions occurred on the right side. All the patients underwent surgical excision. None of our patients had involvement of facial nerve in first branchial anomaly. All patients had tracts going superficial to the facial nerve.Conclusion. Confirming the extent of the tract is mandatory before any surgery as these lesions pass in relation to some of the most vital structures of the neck. Surgery should always be the treatment option. injection of dye, microscopic removal and inclusion of surrounding tissue while excising the tract leads to a decreased incidence of recurrence.

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Saldivar, J. R., J. W. Sechrist, C. E. Krull, S. Ruffins, and M. Bronner-Fraser. "Dorsal hindbrain ablation results in rerouting of neural crest migration and changes in gene expression, but normal hyoid development." Development 124, no. 14 (1997): 2729–39. http://dx.doi.org/10.1242/dev.124.14.2729.

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Our previous studies have shown that hindbrain neural tube cells can regulate to form neural crest cells for a limited time after neural fold removal (Scherson, T., Serbedzija, G., Fraser, S. E. and Bronner-Fraser, M. (1993). Development 188, 1049–1061; Sechrist, J., Nieto, M. A., Zamanian, R. T. and Bronner-Fraser, M. (1995). Development 121, 4103–4115). In the present study, we ablated the dorsal hindbrain at later stages to examine possible alterations in migratory behavior and/or gene expression in neural crest populations rostral and caudal to the operated region. The results were compared with those obtained by misdirecting neural crest cells via rhombomere rotation. Following surgical ablation of dorsal r5 and r6 prior to the 10 somite stage, r4 neural crest cells migrate along normal pathways toward the second branchial arch. Similarly, r7 neural crest cells migrate primarily to the fourth branchial arch. When analogous ablations are performed at the 10–12 somite stage, however, a marked increase in the numbers of DiI/Hoxa-3-positive cells from r7 are observed within the third branchial arch. In addition, some DiI-labeled r4 cells migrate into the depleted hindbrain region and the third branchial arch. During their migration, a subset of these r4 cells up-regulate Hoxa-3, a transcript they do not normally express. Krox20 transcript levels were augmented after ablation in a population of neural crest cells migrating from r4, caudal r3 and rostral r3. Long-term survivors of bilateral ablations possess normal neural crest-derived cartilage of the hyoid complex, suggesting that misrouted r4 and r7 cells contribute to cranial derivatives appropriate for their new location. In contrast, misdirecting of the neural crest by rostrocaudal rotation of r4 through r6 results in a reduction of Hoxa-3 expression in the third branchial arch and corresponding deficits in third arch-derived structures of the hyoid apparatus. These results demonstrate that neural crest/tube progenitors in the hindbrain can compensate by altering migratory trajectories and patterns of gene expression when the adjacent neural crest is removed, but fail to compensate appropriately when the existing neural crest is misrouted by neural tube rotation.

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Richieri-Costa, Antonio, and Lucilene Arilho Ribeiro. "Macrostomia, Preauricular Tags, and External Ophthalmoplegia: A New Autosomal Dominant Syndrome within the Oculoauriculovertebral Spectrum?" Cleft Palate-Craniofacial Journal 43, no. 4 (2006): 429–34. http://dx.doi.org/10.1597/05-060.1.

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Objective First and second branchial arch involvement during early embryonic development results in a wide spectrum of anomalies that encompass diverse, superimposed, and heterogeneous phenotypes within the so-called oculoauriculovertebral spectrum. Nine members of a Brazilian family presenting typical branchial arch involvement in association with external opthalmoplegia are reported. Conclusion Macrostomia or abnormal mouth contour, preauricular tags, and uni- or bilateral ptosis were present in association in several patients. To our knowledge, this is the first report on this type of autosomal dominant condition. Clinical and genetic aspects are discussed.

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Poduval, Jayita. "Branchial arch anomalies: need for early diagnosis." International Journal of Contemporary Pediatrics 1, no. 1 (2014): 46. http://dx.doi.org/10.5455/2349-3291.ijcp20140513.

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Waldhausen, John H. T. "Branchial cleft and arch anomalies in children." Seminars in Pediatric Surgery 15, no. 2 (2006): 64–69. http://dx.doi.org/10.1053/j.sempedsurg.2006.02.002.

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Barakzai, Safia. "Fourth branchial arch defect: a case study." Livestock 18, no. 3 (2013): 86–89. http://dx.doi.org/10.12968/live.2013.18.3.86.

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De Caluwé, D., R. Hayes, M. McDermott, and M. T. Corbally. "Complex branchial fistula: A variant arch anomaly." Journal of Pediatric Surgery 36, no. 7 (2001): 1087–88. http://dx.doi.org/10.1053/jpsu.2001.24762.

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Islam, Md Zahidul, Md Abdur Rahman, and Md Sirajul Islam Mahfuz. "Congenital Anomalies Presenting as Head-Neck Swellings: A Study of 50 Cases." Bangladesh Journal of Otorhinolaryngology 23, no. 2 (2020): 171–79. http://dx.doi.org/10.3329/bjo.v23i2.45164.

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Purpose: To analyse the prevalence, distribution and presentation of different congenital head-neck lesions with their age, sex, site and side predilection. Methods: 50 patients of head-neck congenital swelling was selected from january/2013 upto december/2013 in the OPD of otorhino-laryngology, head and neck deptt. of Dhaka medical college hospital under a specific prospective study protocol. Results: The most frequent swelling was thyroglossal cyst(42%), followed by branchial arch anomalies (18%),dermoid cyst(14%),pre-auricular sinus(14%),lymphangioma(8%) and haemangioma(4%).Amongst the cervical swellings the sequential preponderence was thyroglossal cyst(52%),branchial arch anomalies(23%),dermoid cyst(13%), lymphangioma(10%) and haemangioma (2%).The majority of branchial arch anomalies(100%) were of second arch. The majority of patients were of first(52%) and second(30%) decade and the male to female ratio for thyroglossal cysts was 1:1.1.The majority of lesions were painless swelling and all were surgically excised. Conclusion: The overall frequency and age-sex distribution of congenital head-neck swellings as well as site, nature and type specific predominance of some of them in OPD of Dhaka medical college hospital are almost similar to international findings. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 171-179

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Epperlein, H., D. Meulemans, M. Bronner-Fraser, H. Steinbeisser, and M. A. Selleck. "Analysis of cranial neural crest migratory pathways in axolotl using cell markers and transplantation." Development 127, no. 12 (2000): 2751–61. http://dx.doi.org/10.1242/dev.127.12.2751.

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We have examined the ability of normal and heterotopically transplanted neural crest cells to migrate along cranial neural crest pathways in the axolotl using focal DiI injections and in situ hybridization with the neural crest marker, AP-2. DiI labeling demonstrates that cranial neural crest cells migrate as distinct streams along prescribed pathways to populate the maxillary and mandibular processes of the first branchial arch, the hyoid arch and gill arches 1–4, following migratory pathways similar to those observed in other vertebrates. Another neural crest marker, the transcription factor AP-2, is expressed by premigratory neural crest cells within the neural folds and migrating neural crest cells en route to and within the branchial arches. Rotations of the cranial neural folds suggest that premigratory neural crest cells are not committed to a specific branchial arch fate, but can compensate when displaced short distances from their targets by migrating to a new target arch. In contrast, when cells are displaced far from their original location, they appear unable to respond appropriately to their new milieu such that they fail to migrate or appear to migrate randomly. When trunk neural folds are grafted heterotopically into the head, trunk neural crest cells migrate in a highly disorganized fashion and fail to follow normal cranial neural crest pathways. Importantly, we find incorporation of some trunk cells into branchial arch cartilage despite the random nature of their migration. This is the first demonstration that trunk neural crest cells can form cartilage when transplanted to the head. Our results indicate that, although cranial and trunk neural crest cells have inherent differences in ability to recognize migratory pathways, trunk neural crest can differentiate into cranial cartilage when given proper instructive cues.

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Reddy, Komatreddy G., Poojitha R. G. Venkat, and Katra S. Teja. "An intriguing case of a complete 2nd arch branchial fistula: a portal to the infectious world." International Surgery Journal 9, no. 11 (2022): 1917. http://dx.doi.org/10.18203/2349-2902.isj20222954.

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Complete 2nd arch branchial fistulae are very rare congenital anomalies of head and neck. They arise due to the incomplete obliteration of the branchial clefts during embryonic period. In this article we report a case of type IV 2nd branchial cleft anomaly in a 15-year-old female. Explicit knowledge regarding its development, anatomy and accurate diagnosis, skillful complete excision of the tract is paramount in its management and to prevent recurrence.

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Yolmo, D., J. Madana, R. Kalaiarasi, S. Gopalakrishnan, M. Kiruba Shankar, and S. Krishnapriya. "Retrospective case review of pyriform sinus fistulae of third branchial arch origin commonly presenting as acute suppurative thyroiditis in children." Journal of Laryngology & Otology 126, no. 7 (2012): 737–42. http://dx.doi.org/10.1017/s0022215112000898.

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AbstractObjective:Abnormalities of the third branchial arch are less common than those of the second arch and usually present with left thyroid lobe inflammation. This paper describes 15 cases of pyriform sinus fistulae of third branchial arch origin usually presenting as recurrent thyroid abscess on the left side.Method:A retrospective review of 15 cases of third arch fistulae managed 2000 and 2008, diagnosed based on histopathology and radiological evidence of a fistulous tract, and treated with fistulectomy with left hemithyroidectomy.Results:All patients (six boys and nine girls, aged three to 15 years) presented with recurrent low neck inflammation. Pre-operative ultrasound, computed tomography fistulography and barium swallow demonstrated a third arch fistulous tract, left-sided in all cases. The fistula was detected intra-operatively and pathologically in all cases. Surgery (successful in all cases) emphasised complete recurrent laryngeal nerve and ipsilateral pyriform sinus exposure, to facilitate tract excision, with left hemithyroidectomy. There was no recurrence over three to five years' follow up.Conclusion:Paediatric recurrent low neck inflammatory episodes, due to thyroidal abscess, especially left-sided, should raise suspicion of pyriform sinus fistulae.

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Journal articles on the topic 'Branchial arch'

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