Cysts and fistulas, branchiogenicQ18.0

Symmetrically or asymmetrically occurring (branchiogenic) fistulas, cysts or sinus resulting from developmental disorders in the gillbow apparatus. These can be present at birth or only develop in early adulthood. In rare cases they appear as an autosomal-dominantly inherited disease, possibly combined with other branchiogenic malformations. Branchiogenic malformations lead to cysts and sinus, which are drained outwards through the skin at certain points on the one hand and internally into the pharynx on the other. On the skin they appear as reddish-brown, smooth or swollen papules or plaques, but also as weeping, granulomatous inflammations.

Classification according to localization:

• Nasal fistula and cyst, congenital
• Neck fistula and cyst, lateral
• Neck fistula and cyst, median
• Lower lip fistula and cyst, congenital
• Ear fistula and cyst, congenital.

Mid-neck, preauricular or along the anterior edge of the sternocleidomastoid muscle.

External fistula opening of different size is visible, the fistula tract only to a small extent. Often secretion from the external fistula opening. If the opening is stuck together or if only a part of the duct persists: mucus-filled, bulging cysts which can be palpated under the skin.

Radiological fistula imaging or staining with methylene blue solution possible.

In rare cases carcinomatous degeneration of the epithelial cyst components.

Excision by experienced ENT doctors.