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Branchial Cleft Fistula

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A congenital, abnormal tract connecting the skin of the neck with an internal structure

  • Results from the incomplete closure or development of the branchial arches or associated clefts

  • ...

DIAGNOSIS

HISTORY

  • History of drainage from the cervical area

  • Neck abscess or suppurative thyroiditis

PHYSICAL EXAM

  • Presence of a tiny external opening usually on middle to lower neck along anterior border...

TREATMENT

  • Complete surgical excision is required to prevent recurrence (4).

  • Outpatient status is usually appropriate.

  • Acute infections should be treated with antibiotics first; if this fails to resolve,...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • If infected, follow at weekly intervals until resolution of abscess and inflammatory reaction; then, excise.

  • Postoperative visit at 2 to 3 weeks

  • L...

REFERENCES

1
Nicoucar K, Giger R, Jaecklin T, et al. Management of congenital third branchial arch anomalies: a systematic review. Otolaryngol Head Neck Surg.  2010;142(1):21–28. {L-End} [View Ab...

CODES

ICD10

Q18.0 Sinus, fistula and cyst of branchial cleft 

ICD9

744.41 Branchial cleft sinus or fistula 

SNOMED

204268008 Fistula of branchial cleft 

CLINICAL PEARLS

  • Most common: second branchial cleft anomalies: An opening in the mid-neck at the anterior border of the sternocleidomastoid muscle with a history of an occasional discharge is diagnost...

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