Branchial Cleft Fistula/Cyst

When Presley was born her pediatrician told us that after doing her initial check of Presley she found a dimple like structure on her neck just above her collar bone. She called it a cyst and said that it rarely becomes a problem but that we should watch it and keep it clean to avoid infection. She also said that at some point she would have to get it removed but that if we can make it til she is 1yrs old then it would be best for anesthesia purposes.

During the 4 months that Presley had chronic ear infections we noticed a lot of puss like white stuff that would ooze out of her little hole. Normally it is just clear or a tiny piece of white stuff, but when she had the ear infections it was considerably more. So, Dr.Worthington said, "At her one year birthday she has to go in."

So, off we went yesterday to the Pediatric Surgeon and had him look at her. He took one look at her neck and said "Yep! It is a Branchial Cleft Fistula and it has to come out! We will need to schedule it this month or next month."

What is a branchial cleft fistula? branchial cleft abnormality is a congenital (present from birth) defect that occurs during early embryonic development when the structures and tissues that form the neck and throat do not properly grow together. The tissues form pockets and pathways that contain cells from other parts of the neck and throat. Branchial cleft cysts are lined with skin and lymph cells and contain fluid that is secreted by these cells. Branchial cleft fistulas also contain skin cells but drain mucus and fluids from other internal areas of the neck and throat.
These aren't typically a big deal. What can be a big deal is that since there is essentially a hole to the outside world the internal structure can potentially get badly infected. Presley's fistula seems to be the more common of the tracks that leads to the back of the throat. Which explains why when she has had upper respiratory infections there is more secreted out. It is basically her drainage! Ok, yuck. I realize that is nasty.

Now I am trying to find out if we can get a scan or dye test to make sure the track goes where the doctor expects it to go. Once we have that done they hope to have her in to surgery around the 26th of this month. I know that it isn't a big deal and in the grand scheme of things it could be worse, but I can't help but be nervous. I just think the anesthesia could be scary. Augh! Please keep us and the doctors in your prayers!

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