Branchial fistula: review of literature and case report

Salil Mahajan, Jaya Sorout


The branchial arches are the embryological precursors of the face, neck and pharynx. Second most common congenital lesions of the head and neck in children are the anomalies of the branchial arches, with second arch anomalies by far the most common. Clinically, these congenital anomalies may present as cysts, sinus tracts, fistulae or cartilaginous remnants with typical clinical and radiological findings. We report the case of 11-month-old male child with congenital Type I Second branchial fistula on the left side of neck.


Branchial cyst, Branchial fistula, Branchial apparatus, Congenital cervical lesions

Full Text:



Prasad SC, Azeez A, Thada ND, Rao P, Bacciu A, Prasad KC. Branchial anomalies: Diagnosis and management. Int J Otolaryngol. 2014;2014:237015.

Adams A, Mankad K, offiah C, Childs L. Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings. Insights Imaging. 2016;7:69-76.

Schoenwolf G, Bleyl S, Brauer P, Francis-West P. Larsen’s Human Embryology, 4th edn. Churchill Livingston, New York, Edinburgh; 2019.

Waldhausen J. Branchial cleft and arch anomalies in children. Semin Pediatr Surg. 2006;15:64-9.

Koeller K, Alamo L, Adair C, Smirniotopoulos J. Congenital cystic masses of the neck: radiologic-pathologic correlation. Radiographics. 1999;19(1):121-46.

De PR, Mikhail T. A combined approach excision of branchial fistula. J Laryngol Otol. 1995;109:999-1000.

Ford GR, Balakrishnan A, Evans JN. Branchial cleft and pouch anomalies. J Laryngol Otol. 1992;106:137-43.

Bajaj Y, Ifeacho S, Tweedie D. Branchial anomalies in children. Int J Pediatric Otorhinolaryngol. 2011;75(8)1020-3.

Bailey H. Branchial cysts and other essays on surgical subjects in the fascio-cervical region. London: H. K. Lewis and Company; 1929.

Ang AH, Pang KP, Tan LK. Complete branchial fistula. Case report and review of the literature. Ann Otol Rhinol Laryngol. 2001;110:1077-9.

Augustine AJ, Pai KR, Govindarajan R. Clinics in diagnostic imaging. Sing Med J. 2001;42:494-5.

Harnsberger R. Diagnostic imaging: head and neck, 2nd edn. Amirsys, Lippincott. 2011.

Harnsberger H, Mancuso A, Muraki A, Byrd S, Dillon W, Johnson L, et al. Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 1984;152(3):739-48.

Ahuja A, King A, Metreweli C. Second branchial cleft cysts: variability of sonographic appearances in adult cases. AJNR Am J Neuroradiol. 2000;21:315-9.

Bajaj Y, Tweedie D, Ifeacho S, Hewitt R, Hartley B. Surgical technique for excision of first branchial cleft anomalies: how we do it. Clin Otolaryngol. 2011;36:371-92.

Prasad SC, Azeez A, Thada ND, Rao P, Bacciu A, Prasad KC. Branchial anomalies: diagnosis and management. Int J Otolaryngol. 2014;2014.

Levine PA, Papay FA, Kalucis C, Eliachar I, Tucker HM. Nasopharyngeal presentation of second branchial cleft cyst. Otolaryngol Head Neck Surg. 1994;110(2):232-4.

Ohri AK, Makins R, Smith CE, Leopold PW. Primary branchial cleft carcinoma--a case report. J Laryngol Otol. 1997;111(1):80-2.

Ang AH, Pang KP, Tan LK. Complete branchial fistula: case report and review of the literature. Ann Otol Rhinol Laryngol. 2001;110(11):1077-9.

Mandell DL. Head and neck anomalies related to the branchial apparatus. Otolaryngologic Clinics North America. 2000;33(6):1309-32.

Agaton-Bonilla FC, Gay-Escoda C. Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients. Int J Oral Maxillofacial Surg. 1996;25(6):449-52.