Children's Hospital Colorado
Pediatric Surgery

Branchial Cleft Abnormalities

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What is a branchial cleft cyst, fistula or sinus?

Branchial cleft cysts, fistulas and sinuses are congenital abnormalities, meaning they are present at birth.

These branchial cleft abnormalities (also called branchial cleft anomalies) begin when a baby is an embryo in the womb. During this part of development, the face and neck form from tissues called branchial arches. Each arch is separated by a cleft.

When the tissues do not develop properly, the result can be a branchial cleft cyst, fistula or sinus tract, or a combination of the three.

What causes branchial cleft cysts, fistulas and sinuses?

Branchial cleft cysts, fistulas or sinuses occur when tissues in the neck do not develop normally.

  • A branchial cleft cyst forms if the cleft does not have a connection to the inside or the outside of the neck, and instead fills with fluid.
  • A branchial cleft fistula forms when there is a connection from the inside of the body to the outside of the body through a small opening in the skin.
  • A branchial cleft sinus tract forms if the cleft has an opening on either the inside or the outside of the neck.

Branchial cleft abnormalities are usually seen in front of the large muscles on the sides of the neck. They can form on one side of the neck (unilateral) or both sides of the neck (bilateral). Bilateral branchial cleft abnormalities are often linked with other congenital abnormalities.

Who gets branchial cleft abnormalities (cysts/fistulas/sinuses)?

Branchial cleft abnormalities can be seen in both males and females. Children with other congenital abnormalities may be at higher risk for branchial cleft abnormalities if tissues did not form properly during the embryonic stage of life. Branchial cleft abnormalities are often identified in infancy or at a young age.

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