Congenital branchial apparatus malformation in a Haflinger colt.
Authors: David Florent, Savard Claudine, Drolet Richard, Alexander Kate, Pang Daniel S J, Laverty Sheila
Journal: Veterinary surgery : VS
Summary
# Branchial Apparatus Malformation in Equine Neonates: A Case for Early Surgical Intervention Congenital branchial apparatus anomalies (BAAs) represent a rare but clinically significant developmental condition in foals, potentially causing both airway obstruction and secondary skeletal deformities that warrant prompt recognition and treatment. A 6-day-old Haflinger colt presenting with a fluctuating pharyngeal mass that visibly changed after feeding underwent multimodal imaging (ultrasound, radiography, and computed tomography) which identified a communicating tract between the cystic mass and pharynx—a finding confirmed during upper airway endoscopy—allowing precise surgical planning and removal of the third branchial sinus along with ligation of its pharyngeal communication. Complete surgical excision resulted in both excellent functional and cosmetic outcomes, with resolution of the associated mandibular deformity within two years without requiring corrective intervention. Because BAAs can compromise the neonatal airway and induce secondary mandibular malformation *in utero*, early surgical referral is essential; however, the encouraging prognosis in young patients suggests that associated skeletal abnormalities may spontaneously resolve following definitive removal of the underlying lesion. Equine practitioners should include branchial apparatus anomalies in their differential diagnosis when encountering throatlatch masses in neonatal foals and refer for complete surgical excision rather than conservative management.
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Practical Takeaways
- •Include branchial apparatus anomalies in your differential diagnosis for any fluctuating mass in the throatlatch region of neonatal foals, particularly if the mass changes size with feeding.
- •Early surgical intervention with complete excision of the branchial tissue and tract ligation is recommended and offers excellent functional and cosmetic outcomes without need for additional mandibular correction.
- •Do not assume associated mandibular deformities are permanent; conservative management in young foals may result in complete spontaneous resolution following BAA removal.
Key Findings
- •A 6-day-old Haflinger foal presented with a fluctuating cystic mass in the throatlatch region that changed appearance after milk ingestion, consistent with a communicating branchial sinus tract.
- •Combined diagnostic imaging (ultrasonography, radiography, CT) successfully identified the anatomic location and communication pathway between the cystic mass and pharyngeal lumen.
- •Surgical resection of the branchial cyst with ligation of the pharyngeal communication resulted in complete resolution with no evidence of mandibular deformity at 2-year follow-up.