
A 6-month-old presented with a congenital neck sinus coursing between the carotid and parotid spaces, terminating near the stylomastoid foramen. MRI and pathology revealed features of both first and second branchial anomalies, including a keratinous squamous lining, skin adnexae, and elastic cartilage. Given these intermediate characteristics, we propose the term "sesquialter (first and a halfth) branchial anomaly" for this rare entity.
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