A newborn presents with bilateral preauricular pits (Figures 1, 2)

The infant was active, feeding well, and vital signs were stable. However, the findings on physical examination prompted admission to the neonatal intensive care unit for further evaluation.

The infant’s mother was noted to have bilateral preauricular pits and a sinus over the medial border of the left sternocleidomastoid muscle. She also had mild deafness bilaterally. She recollected that her father too had bilateral preauricular pits and a sinus on the left side of his neck.

Branchial cleft anomalies account for almost 30% of congenital neck masses. They can present as cysts, sinuses, or fistulae. There is no sex predilection, and they may present later in life. Differential diagnoses of branchial cleft anomalies include adenopathy, thyroglossal duct anomalies, lymphatic malformations such as cystic hygroma, dermoid cysts, and cervical clefts. In our patient, the anatomical position of the...

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