Branchial Cleft Abnormality

A branchial cleft abnormality is located in the area around the ear or in the neck region. It may form cysts—pockets that contain fluid—or it may form passages that drain to an opening in the skin surface called fistulas. It is often present at birth or childhood but sometime does not become apparent until adulthood.

Causes of Branchial Cleft Abnormality

A branchial cleft abnormality is a birth defect that occurs during early embryonic development when the structures and tissues that form the ear, neck and throat areas do not properly grow together.

Symptoms of Branchial Cleft Abnormality

Most branchial cleft cysts or fistulae are asymptomatic, but they may become infected. The cyst usually presents as a smooth, slowly enlarging lateral neck mass that may increase in size after an upper respiratory tract infection. These abnormalities are usually small, but can enlarge enough to cause difficulty swallowing and breathing.

The following are the most common symptoms of a branchial cleft abnormality:

  • A small lump or mass near the ear area or to the side of the neck near the front edge of the sternocleidomastoid muscle (usually only on one side of the neck, rarely on both sides). It is usually painless unless infected.
  • A small opening in the skin that drains mucus or fluid near the ear area or along the front edge of the sternocleidomastoid muscle.

Treatment for Branchial Cleft Abnormality

Medical Treatment

Antibiotics can be successfully used to treat infectious processes associated with branchial cleft abnormality.

Surgical Treatment

Branchial cleft abnormalities often become recurrently infected therefore they are usually removed with surgery. The surgery is done in the operating room, under general anesthesia. The cyst and any associated fistula are completely removed, while preserving the important adjacent structures.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have a branchial cleft abnormality and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced otolaryngologist are important to the successful outcome for patients with ear, nose and throat disorders and conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by otolaryngologist, anesthesiologists and nurses who specialize in surgery for patients with branchial cleft abnormalities. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by experienced surgical and nursing staff.

Learn more about your hospital stay, patient-centered care and returning home.

Multidisciplinary Care

Brigham and Women’s Hospital provides a multidisciplinary approach to patient care by collaborating with colleagues who have extensive experience in diagnosing and treating ear, nose and throat disorders and conditions. In addition, patients have full access to BWH’s world-renowned academic medical community, with its diverse specialists, and state-of-the-art facilities.

Otolaryngology-Head and Neck Surgery Appointments and Locations


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