First branchial cleft fistula: case reports and literature review.

The 1st branchial cleft accounts for about 5% of branchial arch anomalies. The necessity for wide surgical exposure to delineate the anatomy between the facial nerve and tract is stressed; migrating mesenchyme, which brings with it the facial nerve, can orientate medically, laterally or both sides of the tract. Three cases and a literature review are presented.