Congenital remnants of the first branchial pouch and cleft are uncommon and may only be detected if they become infected.
First Branchial
Derivative
arch
incus body, Meckel's cartilage, body of tongue, malleus, tragus
cleft
external auditory canal
pouch
Eustachian tube, middle ear cavity, mastoid air cells
Defects ascribed to the first cleft and pouch:
(1) congenital preauricular pit, sinus or cyst (first arch; may be from the second arch)
(2) cervicoaural sinus, cyst or fistula (duplicated external auditory canal that extends into the retroaural crease, sinus from the external auditory canal to the upper neck in the region of the parotid gland; first cleft)
(3) nasopharyngeal sinus or cyst (first pouch)
(4) anomalies of the Eustachian tube (first pouch)
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