Bilateral branchial arch anomaly: a rare case report

Saurabh Tiwari, Apoorva Kulkarni, Abhaya Gupta, Paras Kothari


Anomalies of branchial arches are uncommon anomalies of embryonic development and may present as cysts, sinus tracts, fistulae or cartilaginous remnants. They represent the embryological precursors of face, neck and pharynx and are the second most common congenital lesions of head and neck in children. Although pharyngeal apparatus (branchial) anomalies are frequently seen, bilateral cases are rare (only 2% to 3%). Our patient was a 3 months old child with a swelling on right side of neck and discharging sinus from left side since birth. Surgical excision of the right branchial cyst with its complete tract was done along with excision of the left branchial fistulous tract upto the tonsillar fossa. Post-operative course was uneventful and patient was discharged the next day.


Branchial apparatus, Cyst, Fistula, Sinus

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Adams A, Mankad K, offiah C, Childs L. Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings. Insights Imaging. 2016;7:69-76.

Prasad SC, Azeez A, Thada ND, Rao P, Bacciu A, Prasad KC. anomalies: Diagnosis and management. Int J Otolaryngol. 2014;2014:237015.

Harnsberger H, Mancuso A, Muraki A, Byrd S, Dillon W, Johnson L, et al. Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiol. 1984;152(3):739-48.

Ford GR, Balakrishnan A, Evans JNG, Bailey CM. Branchial cleft and pouch anomalies. J Laryngol Otol. 1992;106(2):137-53.

Gupta AK, Kumar S, Jain A. Bilateral first and second branchial cleft fistulas: a case report. Ear Nose Throat J. 2008;87(5):291-3.

Huang RY, Damrose EJ, Alavi S. Third branchial cleft anomaly presenting as a retropharyngeal abscess. Int J Ped Otorhino. 2000;54(2-3):167-72.

Vent J, Grier CG, Leopold DA, Heywood BB. Congenital familial bilateral branchial tracts: a rare case. Ear Nose Throat J. 2008;87(1):48-50.

Gatti WM, Zimm J. Bilateral branchial cleft fistulas: diagnosis and management of two cases. Ear Nose Throat J. 1988;67:256-61.

Nakahara Y, Aoyama K, Goto T, Iwamura Y, Takahashi Y, Asai T. Modified Collis-Nissen procedure for long gap pure esophageal atresia. J Pediatr Surg. 2012;47(11):31-2.