Branchial Cleft Cyst/Sinus/Fistula
During early prenatal development, gill-like structures (branchial) usually resorb but in rare circumstances, they may remain. These structures may connect with the skin only and drain sloughed skin through a small opening on the skin (branchial sinus); with the skin and the throat lining and drain mucous through a small opening on the skin (branchial fistula); or have no connection at all and slowly grow over time (branchial cyst). All of these are referred to as branchial anomalies.
Branchial anomalies typically are present on the front of the neck, but may be seen anywhere from the lowest portion of the neck, the thyroid gland or to the area around the ear. Branchial anomalies may be present at birth, or may become enlarged during or following an upper respiratory tract infection.
If your child has a draining pit on their neck or around the ear, or if there is an area of fullness in the neck, this may represent a branchial anomaly. After careful examination of the head, neck, ears, nose and throat, additional testing may be needed to more fully understand the course of the branchial anomaly. Most often, an ultrasound exam will be ordered, but at times, a CT scan or magnetic resonance imaging (MRI) scan will be performed. There is no medication that can treat this problem, but branchial anomalies can be removed surgically.