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Branchial Cleft Fistula

Mark M. Butterly, MD Reviewed 06/2019
 


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

GENERAL MEASURES

  • Acute infections should be treated with antibiotics first; if this fails to resolve, needle aspiration under US guidance may be required (4)[C]. Typical offending organisms i...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

  • Postoperative visit at 2 to 3 weeks

  • Lack of epithe...

REFERENCES

1
LaRiviere CA, Waldhausen JH. Congenital cervical cysts, sinuses, and fistulae in pediatric surgery. Surg Clin North Am.  2012;92(3):583–597. [View Abstract on OvidMedline]
2
Geddes G, B...

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

  • Branchial cleft remnants, sinuses, and cysts result from the failure of branchial arches to close and/or complete their normal embryologic development.

  • Second branchial cleft anomalies ...

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