Midline cervical branchial fistula with a branchial cyst in the sublingual space: A case report

Introduction: Branchial fistulas and cysts are congenital abnormalities that generally occur on the lateral aspect of the neck and predominantly arise as remnants of a branchial cleft. We report herein a case of a patient with a residual first branchial cleft with a branchial fistula on the midline neck and a branchial cyst in the sublingual space. Case presentation: A 4-month-old boy presented to our institute with a history of white secretion drain from the midline neck beginning 1 week prior to presentation. A cutaneous fistula was identified on the midline of the neck. Radiography of the fistula following injection of contrast agent revealed that it was connected to the cyst near the left jaw. Excision of the cyst and fistula was performed, and histopathological examination confirmed a branchial cyst with a branchial fistula. Conclusion: Our experience with the present case suggests that branchial cysts should be differentiated from diseases that form cutaneous fistulas on the midline neck with cystic lesions in the sublingual space. It is important to perform preoperative imaging and complete resection without any remnants to prevent recurrence.