Tracheal Deviation and Life-threatening Presentation of Congenital Branchial Cleft Cyst Abscess due to Rare Pathogens and Difficult Airway Management

Airway management can be a challenging and sometimes life-threatening situation in children in the presence of intraoral or neck pathologies. Branchial cleft cysts which are benign and slow-growing constitute 20% of all congenital pediatric head and neck masses (Geddes G et al., Pediatr Rev 2013; 34 (3): 115– 125) Stridor, tracheal deviation and acute upper airway obstruction secondary to branchial cleft cyst abscess are very rare. In this report, we present the difficult airway management of a pediatric case with severe tracheal compression and deviation due to brachial cleft cyst infection secondary to Acinetobacter Junii, Streptococcus anginosus, and S. constellatus. Multidisciplinary airway management with a good communication between pediatricians, surgeons and anesthesia provides a successful and life-saving management with rapid diagnosis and rapid intervention.