If you accidentally notice a small hole in your child’s neck, or a swelling that feels like a rubber or that waxes and wanes, or even an infection that breaks down and forms a scar on the skin, sometimes with a history of an antecedent upper respiratory infection, you may want to bring your child to the doctor. When any of the above occurs, you are encouraged to bring your child to the doctor promptly as he may have a gill slit cyst or gill slit fistula. Sometimes it is accompanied by localized neck pain when pressed, sometimes swelling, and a pulling sensation when eating and swallowing. Even more serious, you see your child’s face is not symmetrical, eating and drinking water drop rice leakage and other symptoms of facial paralysis. Gill slit cysts and fistulas are congenital gill slit malformations and account for about 30% of congenital anomalies of the neck. Gill slit malformations can occur at any age, fistulas are most often recognized in infancy, and cysts tend to occur in childhood or adolescence. A small percentage of malformations also become malignant. When you bring your child to the hospital, our doctors will take a detailed medical history and perform a specialized examination. At the same time, an ultrasound of the neck and thyroid will be done to determine the nature and extent of the mass; laryngoscopy is necessary to detect any internal fistula that is connected to the hypopharynx; a normal and lateral neck radiograph can be used for children with external fistulae that can be seen in the skin of the neck, and a film can be taken after injecting a contrast medium into the fistulae in order to observe the fistulae/sinus tracts; an enhanced nuclear magnetic resonance imaging (NMRI) of the neck will be used to observe the morphology and extent of the lesion; and a thyroid function test will be used to determine the presence of a decreased function of the thyroid gland. The thyroid function test is used to determine whether the thyroid function is declining or not. The doctor will then make a clinical diagnosis based on the history, clinical presentation, location of the lesion, ultrasound and MRI. However, the diagnosis should be confirmed by supported laryngoscopy under general anesthesia to exclude pyriform fossa fistula, and combined with postoperative pathology results to finalize the diagnosis. Currently, the two methods of treatment are complete surgical resection and supported post-laryngoscopic CO2 laser cauterization. Under general anesthesia, after the support laryngoscope has not explored and obvious internal fistula and can clearly exclude the pyriform fossa fistula, an external neck incision is made to remove the swelling. However, in the case of acute infection or abscess formation, the abscess must be drained and the infection controlled before elective surgery, the specific time need to consult with the surgeon, usually about one month after the infection has healed. Successful and satisfactory treatment is what every doctor and parent looks forward to. However, you need to understand that there is a certain recurrence rate after surgery, and the recurrence may increase the chance of cancer, so you need to decide the further treatment plan according to the pathological results. Finally, I hope the above information can be helpful to you and your child, and I sincerely wish your child grows up healthy and happy.