Thyroglossal and Branchial Cysts, Sinuses, and Fistulas

Living reference work entry


Congenital fistulas, cysts, or sinuses in the neck region consist either of branchial anomalies which arise from incomplete obliteration of pharyngeal clefts and pouches during embryogenesis or from failure of obliteration of the thyroglossal duct that was formed during the descent of the thyroid gland. The most common clinical sign is infection of the remnants, and appropriate surgical therapy is needed.


Thyroglossal duct Thyroglossal cyst Hyoid bone Thyroid gland Foramen cecum Branchial cysts Branchial sinuses Branchial cleft Facial nerve Hypoglossal nerve Laryngeal nerve 


  1. Allard RH. The thyroglossal cyst. Head Neck Surg. 1982;5:134–6.CrossRefPubMedCentralGoogle Scholar
  2. Amos J, Shermetaro C. Thyroglossal duct cyst. Treasure Island: StatPearls Publishing; 2019.Google Scholar
  3. Bajaj Y, Ifeacho S, Tweedie D, et al. Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 2011;75:1020–3.CrossRefPubMedCentralGoogle Scholar
  4. Brooks JA, Cunningham MJ, Koempel JA, et al. To drain or not to drain following a Sistrunk procedure: a dual institutional experience. Int J Pediatr Otorhinolaryngol. 2019;127:109645.CrossRefPubMedCentralGoogle Scholar
  5. D’Souza AR, Uppal HS, Zeitoun H, et al. Updating concepts of first branchial cleft defects: a literature review. Int J Pediatr Otorhinolaryngol. 2002;62:103–9.CrossRefGoogle Scholar
  6. Diaz MC, Stormorken A, Christopher MC. A thyroglossal duct cyst causing apnea and cyanosis in a neonate. Pediatr Emer Care. 2005;21:35–7.CrossRefGoogle Scholar
  7. El-Gohary Y, Gittes G. Congenital cysts and sinuses of the neck. In: Puri P, editor. Newborn surgery. 3rd ed. London: Hodder Arnold; 2011.Google Scholar
  8. Foley DS, Fallat ME. Thyroglossal duct and other congenital midline cervical anomalies. Sem Pediatr Surg. 2006;15:70–5.CrossRefGoogle Scholar
  9. Golf CJ, Allred C, Glade RS. Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 2012;20:533–9.CrossRefGoogle Scholar
  10. Höllwarth EM. Branchial cyst and sinus. In: Puri P, Höllwarth M, editors. Pediatric surgery. Springer Surgery Atlas series. Berlin/Heidelberg: Springer; 2019a.Google Scholar
  11. Höllwarth ME. Thyroglossal duct cyst. In: Puri P, Höllwarth M, editors. Pediatric surgery. Springer surgery atlas series. Berlin/Heidelberg: Springer; 2019b.Google Scholar
  12. Höllwarth ME. Thyreoglossal and branchial cysts, sinuses and fistulas. In: Puri P, Höllwarth M, editors. Pediatric surgery: diagnosis and management. Berlin/Heidelberg: Springer; 2009.Google Scholar
  13. Kim MG, Lee NH, Ban JH, et al. Sclerotherapy of branchial cleft cysts using OK-432. Otolaryngol Head Neck Surg. 2009;141:329–34.CrossRefPubMedCentralGoogle Scholar
  14. Lillehei C. Neck cysts and sinuses. In: Coran AG, Adzick NS, Krummel TM, Laberge J-M, Shamberger RC, Caldamone AA, editors. Pediatric surgery. 3rd ed. Philadelphia: Elsevier; 2012.Google Scholar
  15. Madana J, Yolmo D, Kalaiarasi R, et al. Recurrent neck infection with branchial arch fistula in children. Int J Pediatr Otorhinolaryngol. 2011;75:1181–5.CrossRefPubMedCentralGoogle Scholar
  16. Maddalozzo J, Rastatter JC, Dreyfuss HF, et al. The second branchial cleft fistula. Int J Pediatr Otorhinolaryngol. 2012;76:1042–5.CrossRefPubMedCentralGoogle Scholar
  17. Magdy EA, Ashram YA. First branchial cleft anomalies: presentation, variability and safe surgical management. Eur Arch Otorhinolaryngol. 2013;270:1917–25.CrossRefPubMedCentralGoogle Scholar
  18. Nicoucar K, Giger R, Pope HG Jr, et al. Management of congenital fourth branchial arch anomalies: a review and analysis of published cases. J Pediatr Surg. 2009;44:5–10.CrossRefGoogle Scholar
  19. Nicoucar K, Giger R, Jaecklin T, et al. Management of congenital third branchial arch anomalies: a systematic review. Otolaryngol Head Neck Surg. 2010;142:21.e2–8.e2.CrossRefGoogle Scholar
  20. Nixon PP, Healey AE. Treatment of a branchial sinus tract by sclerotherapy. Dentomaxillofac Radiol. 2011;40:130–2.CrossRefPubMedCentralGoogle Scholar
  21. Olsen KD, Maragos NE, Weiland LH. First branchial cleft anomalies. Laryngoscope. 1980;90:423–36.CrossRefPubMedCentralGoogle Scholar
  22. Pereira KD, Losh GG, Oliver D, et al. Management of anomalies of the third and fourth branchial pouches. Int J Pediatr Otorhinolaryngol. 2004;68:43–50.CrossRefPubMedCentralGoogle Scholar
  23. Peretz A, Leibermann E, Kapelushnik J, et al. Thyroglossal duct carcinoma in children: case presentation and review of the literature. Thyroid. 2004;14:777–85.CrossRefPubMedCentralGoogle Scholar
  24. Radkowski D, Arnold J, Healy GB, et al. Thyroglossal duct remnants: preoperative evaluation and management. Arch Otolaryngol Head Neck Surg. 1991;117:1378–81.CrossRefPubMedCentralGoogle Scholar
  25. Roh JL, Sung NH, Kim H, et al. Treatment of branchial cleft cyst with intracystic injection of OK-432. Acta Otolaryngol. 2006;126:510–4.CrossRefPubMedCentralGoogle Scholar
  26. Sadler TW. Langman’s medical embryology. 10th ed. Philadelphia/Baltimore: Lippincott Williams & Wilkins; 2006.Google Scholar
  27. Van Vuuren PA, Balm AJ, Gregor RT, et al. Carcinoma arising in thyroglossal duct remnants. Clin Otolaryngol. 1994;19:509–15.CrossRefPubMedCentralGoogle Scholar
  28. Wadsworth DT, Siegel MJ. Thyroglossal duct cysts: variability of sonographic findings. Am J Roentgenol. 1994;163:1475–7.CrossRefGoogle Scholar
  29. Waldhausen JHT. Branchial cleft and arch anomalies in children. Sem Pediatr Surg. 2006;15:64–9.CrossRefGoogle Scholar
  30. Work WP. Newer concepts of the first branchial cleft defects. Laryngoscope. 1972;82:1581–93.CrossRefPubMedCentralGoogle Scholar

Authors and Affiliations

  1. 1.Department of Paediatric and Adolescent SurgeryMedical UniversityGrazAustria

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