A First Branchial Cleft Cyst Masquerading as a Chronic Non-Healing Wound

Ng Syiao Wei (MBBS, Resident, Department of Otorhinolaryngology, University Malaya Medical Centre, Kuala Lumpur, 59100, Malaysia)
Aaron Wong Chun Chian (MBBS, Resident, Department of Plastic and Reconstructive Surgery, Hospital Sultanah Aminah, Johor, 80100, Malaysia)
Aziah Ab Rani (MS, Otorhinolaryngologist, Department of Otorhinolaryngology, Hospital Sultanah Aminah, Johor, 80100, Malaysia)
Yoke Chin Mun (MD, FRCS, Surgeon, Department of Plastic and Reconstructive Surgery, Hospital Sultanah Aminah, Johor, 80100, Malaysia)
Jothi Shanmuganathan (MS, Otorhinolaryngologist, Department of Otorhinolaryngology, Hospital Sultanah Aminah, Johor, 80100, Malaysia)

Sumatera Medical Journal
Vol. 8 No. 2 (2025): Sumatera Medical Journal (SUMEJ)

Background: First branchial cleft anomaly exhibits variable clinical features, ranging from a painless swelling, discharging sinus or pit, to recurrent infection. It could be easily misdiagnosed and mismanaged, resulting in recurrence.  Hence, any swellings or pits in Poncet’s triangle with a history of recurrent infection should raise the suspicion of a first branchial cleft anomaly. Objective: To present a case of chronic non-healing wound caused by an incompletely excised first branchial cleft anomaly. Methods: Case observation of a patient with a history of incomplete excision of a first branchial cyst. Results: Our patient was a case of incompletely excised first branchial cyst which subsequently presented as a chronic non- healing wound. She had undergone several workup for non-healing wound resulting in delay in receiving definitive treatment. Conclusion: Early recognition of first branchial cleft anomalies is important to prevent chronic complications and mismanagement.