A Case Report on Branchial Cleft Fistula

Abstract

Background: Branchial cleft anomalies (BCA) are a rare head and neck condition that affects nearly one million people each year. They are found below the external auditory canal, above the hyoid bone, anterior to the sternocleidomastoid, and posterior to the submandibular triangle. Because brachial cleft cysts are uncommon and present with unexpected clinical signs and symptoms, they are commonly misdiagnosed. The child had a discharge from the right upper region of his neck. A bulge in the right upper lateral region of the neck was present, as was an aperture in the floor of the right external auditory canal (EAC).  A 4.8 cm long obliquely oriented fistulous tract opening was seen on contrast enhanced computed tomography of the neck at the intersection of the middle and upper one third of the sternocleidomastoid, with an opening in the right EAC. The fistulous tract was surgically removed while the facial nerve was preserved. The presence of a fistula was verified by histopathology. Pre-auricular swelling (24 percent), parotid edoema (36 percent), and cervical area swelling are the most common clinical manifestations of BCAs (41 percent ).

Clinical findings: Watery discharge from left lower part of neck white swallowing since birth. Then he went to AVBR Hospital. Patient was appropriately alright, when her mother noticed whatery descharge from left lower part of neck which was sudden in out and non progressive in mature, 1-2 drops clear watery in continuously.

Diagnostic evaluation: Chest x-ray ,ESR, Serum Ferrintin, Urea, creatinine, Kidney function tests,  Liver function tests, CT Scan.

Therapeutic intervention: Multivitamins, alpha and beta-blockers, angiotensin receptor blockers, antibiotics, and vitamin C were used to treat the patient.

Conclusion: A member of the health team initiated prompt treatment and administered all available treatments, but the patient's condition remains unsatisfactory.