Definition
A neck fistula is a tube-like connecting passage between the inner pharynx and a punctiform opening in the neck. There are lateral (lateral) or medial (anterior) neck fistulas, whereby a distinction is made between primary and secondary fistulas. Neck fistulas belong to the group of primary fistulas, i.e. they are congenital and result from congenital malformations during embryonic development.
Causes
Neck fistulas are congenital malformations that are caused by degenerative disorders during the development of the neck fistula in the womb. During embryonic development, a duct is formed in the area of the neck, which normally closes again at a later stage of development. In some cases, this duct remains and a neck fistula develops.
The fistula duct is lined with covering tissue (epithelium) that produces mucus and fluid. The mucus accumulates in the fistula and a fluid-filled cavity (cyst) develops. This cyst is clearly palpable as a noticeable swelling in the neck area. The accumulated fluid can occasionally drain to the outside through an opening in the skin.
Diagnosis
The physician recognizes a neck fistula by means of a gaze diagnosis and a physical examination in which the neck is palpated. The fistula is noticeable as a palpable bulging under the skin in the neck area. In addition, the fistula is movable, i.e. it can be moved by swallowing.
Imaging techniques such as ultrasound (sonography) are used to confirm the diagnosis. The neck fistula can be recognized as a sharply defined mass (tissue growth). In unclear cases, an additional magnetic resonance tomography (MRT) can be performed for better imaging.
Associated symptoms
A neck fistula is noticeable as a painless swelling or thickening of the neck, otherwise the affected persons usually have no complaints. If the fistula becomes inflamed, there is a severe swelling in the neck area and difficulty swallowing. The inflamed tissue reddens and eczema can form on the skin.
If the inflammation spreads, the body reacts with fever. At the latest then a doctor should be consulted. The inflamed neck fistula hurts and can harden and form an abscess (encapsulated purulent accumulation) under the skin. Occasionally the fistula wets and fluid or pus empties through a small opening on the skin.
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