Pediatric Branchial Cleft Abnormalities

A branchial cleft abnormality is a cluster of abnormally formed tissue in the neck. Branchial cleft abnormalities may form:

• Cysts or sinuses. These are pockets full of fluid.
• Fistulas. These are passages that drain to an opening in the skin surface.

Branchial cleft abnormalities are often found in front of the large muscles on either side of the neck.

This health problem can cause local infections that keep coming back. This may happen when your child has another infection, such as a cold, cough or sore throat.

A branchial cleft abnormality is a birth defect. It happens when the tissue in the neck does not form as it should during the early stages of an embryo’s development.

These are the most common symptoms of a branchial cleft abnormality:

• Small lump or mass on one side of the neck that is often painless
• Small opening in the skin on the side of the neck that drains mucus or fluid
• Redness, warmth, swelling, pain and drainage if there is an infection

The symptoms of a branchial cleft abnormality can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

This health problem may be seen at birth. Or it may be noticed when your child is older.

To diagnose the problem, your child’s healthcare provider will ask you questions about your child’s health history and current symptoms. They will examine your child, paying close attention to his or her neck. A branchial cleft abnormality may not be noticed unless it becomes infected and is painful.

Diagnostic tests may include:

• Ultrasound. Sound waves are used to look at the area. 
• CT scan. X-rays and a computer are used to make detailed images of the body. CT scans help to find the exact location of the abnormality and how large it is. Sometimes dye may also be used during the scan to get even more detailed information.
• Biopsy. For this test, tissue samples are removed from the body to be looked at under a microscope. This may be done to check for other conditions.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

A branchial cleft abnormality will not go away without treatment. Treatment may include:

• Antibiotic medicine if your child has an infection. In some children, the healthcare provider may need to cut into and drain the area.
• Surgery to remove the tissue. This may be advised to prevent repeated infections.

Branchial cleft abnormalities are often small. But they can become large enough to cause trouble swallowing and breathing. Repeated infections are common.