Branchial Cleft Cysts and Sinus Tracts in Children: Diagnosis and Treatment

 How Are Branchial Cleft Cysts and Sinus Tracts Diagnosed in Children?

A physical exam is usually enough to diagnose a branchial cleft cyst. Sometimes, MRI or CT scans can check the exact location of the cyst. Ultrasounds can also help figure out whether there is a fistula (unusual connection between two organs) connecting the throat or ear canal.

How Are Branchial Cleft Cysts and Sinus Tracts Treated in Children?

Currently, there is no medication that can treat branchial anomalies. If the cyst or sinus tract is infected, your child may need antibiotics.

Surgery is the most common treatment to permanently remove branchial cleft cysts and sinus tracts. Most surgeons remove sinus tracts and cysts through a small incision in the neck. Because sinus tracts can span across the length of the neck, the pediatric surgeon might make two small incisions to avoid creating one long incision. In some rare cases, the pediatric surgeon may be able to close off internal openings without creating incisions.

Sometimes, small tubes are placed during surgery to allow fluid to drain out of the skin. Usually dissolvable sutures (stitches) help to close incisions. This means your child will not need to return to the hospital to have their stitches removed.  

In most cases, children return home on the same day as the surgery. If there is a concern that a swelling in the neck might affect your child’s breathing, they will stay overnight at the hospital for one night.

What Are the Risks of Surgery for Branchial Cleft Cysts?

The risks of surgery to treat branchial cleft cysts include:

• Nerve and blood vessel damage in the neck
• Infection in the surgical area
• If an infection in a branchial cleft cyst is not treated before surgery, there is a higher chance that the cyst may come back later. There is also a higher chance of injury to other structures close to the surgical site (the location on the body where your child had surgery) in the neck.