Some preliminary knowledge of embryology is essential to
understand the formation of branchial fissures, and we refer the
reader to any of the standard works on embryology for this
information. Dzondi was one of the first to recognize and
classify congenital fistulas of the neck. The proper
classification is into lateral and median fissures. In a case
studied by Fevrier the exploration of a lateral pharyngeal
fistula produced by the introduction of the sound violent reflex
phenomena, such as pallor of the face and irregular, violent
beating of the heart. The rarest of the lateral class is the
preauricular fissure, which has been observed by Fevrier, Le
Dentu, Marchand, Peyrot, and Routier.
The median congenital fissures of the neck are probably caused by
defective union of the branchial arches, although Arndt thinks
that he sees in these median fistulas a persistence of the
hypobranchial furrow which exists normally in the amphioxus. They
are less frequent than the preceding variety.
The most typical form of malformation of the esophagus is
imperforation or obliteration. Van Cuyck of Brussels in 1824
delivered a child which died on the third day from malnutrition.
Postmortem it was found that the inferior extremity of the
esophagus to the extent of about two inches was converted into a
ligamentous cord.
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