A two-year-old with a duplicated external auditory canal; a first branchial cleft anomaly

First branchial cleft anomalies are uncommon. They may present as cysts, sinuses or fistulae and can occur anywhere along the course of the first branchial arch tract. The current classification system is based on both histological and clinical features. Surgical excision with monitoring of the facial nerve is the accepted treatment of choice. We present a case of a 2-year old with a duplication of the external auditory canal, based on a first branchial cleft anomaly. Based on clinical presentation this case is classified as first branchial cleft sinus Work Type 1 with ectodermal and mesodermal derivatives. Marsupialization through the cartilaginous external auditory canal proved to be an effective and minimally invasive treatment.