What is this disease?

• The baby neck and face forms from  five basic building blocks called the branchial arches. Each arch is separated by a groove or cleft. A persistence of this cleft with an opening to the outside (or inside) of the neck is called a sinus tract. If this cleft persists with no communication to the outside or inside of the neck, it may fill with fluid, resulting in a branchial cleft cyst. If the opening is both inside mouth and neck, it is called fistula. A child may can have both a sinus tract and cyst.

How it is diagnosed?

• It is diagnosed by clinical examination

How it is treated?

• Surgical excision is the treatment of choice

When it should be operated?

• There is typically no urgency; so, one can defer excision beyond 3 to 6 months of age or to allow treatment of an acute infection.

Are there other alternative methods of treatment?

• Medical management is not successful in this disease.

What all I need to know before my child surgery?

• Read “All you need to know before your child's surgery” information booklet in website.

How is the surgery done?

• Second branchial cleft anomalies are excised with the neck positioned in slight hyperextension and the head turned away from the lesion . These sinus tracts may require a stepladder counterincision to visualize and dissect the entire tract . The tract courses between internal and external carotid arteries, ultimately terminating in the tonsillar fossa

Remarks

• For more details of surgery, contact your surgeon

Related Photographs and videos

• Few photographs of steps done by me  is given here for learning purposes