A branchial cleft anomaly is a cluster of abnormal tissue that forms in a child’s neck. It happens in the early stages of an embryo’s development when the neck and throat tissues do not grow properly and form abnormal pockets and pathways. There are two types of branchial cleft anomalies: cysts, sinuses or pits (deep tissue pockets that fill with fluid) and fistulas (passages that drain from internal tissues to an opening on the skin’s surface). Sometimes a branchial cleft anomaly is found when your baby is born, but it may not be detected until your child is older. Most are small, but they can grow large enough to cause your child difficulty with swallowing or breathing. They can also become infected, and these infections can keep coming back. Branchial cleft and other neck anomalies are typically found during a physical exam. Your doctor may request additional diagnostic tests, including an ultrasound, CT or biopsy, to better understand your child’s specific anomaly. Treatment will depend on your child’s age and condition. Antibiotics are typically prescribed to address infection. Surgery may be needed to remove the affected tissue and prevent additional infections from occurring. AdventHealth for Children’s Pediatric Head and Neck Surgery team cares for a full range of branchial cleft and other neck anomalies, including: Dermoid cysts Giant congenital melanocytic nevi Pilomatrixoma Preauricular pits Pyogenic granuloma (PG)