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Branchial Cleft Cyst
Aka: Branchial Cleft Cyst, Branchial Cleft Sinus, Branchial Cleft, Branchial Cyst, Branchial Sinus, Congenital Branchial Cleft Cyst
- Pathophysiology
- Congenital remnant of Branchial Cleft
- Branchial Clefts embyogenesis
- Composed of 5 paired arches in lateral foregut wall
- Arches are separated by clefts
- Clefts usually obliterated with development
- Types
- First Branchial Cleft
- Associations
- External auditory canal
- Parotid Gland
- Second Branchial Cleft
- Associations
- Superior pole of Tonsil
- Location
- Anterior border of sternocleidomastoid Muscle
- Course
- Between internal and external carotid arteries
- Opens into Tonsillar fossa
- Third Branchial Cleft
- Associations
- Pyriform Sinus
- Location
- Anterior border of sternocleidomastoid Muscle
- Course
- Posterior to common Carotid Artery
- Opens in Pyriform sinus
- Signs
- Lateral Neck Mass in distribution as above
- Most common at anterior border of sternocleidomastoid
- Sinus communicates fully between skin and airway
- May present with infection
- Complications
- Secondary infection with neck abscess
- Branchial Cleft Cyst wall carcinoma (rare)
- Differential Diagnosis
- See Neck Masses in Children
- See Neck Masses in Adults
- Squamous Cell Carcinoma of Tonsil or Tongue base
- Radiology
- CT Neck
- Fistulogram
- Management
- Surgical Excision of cyst and sinus tract
- References
- Noble (2001) Primary Care, Mosby, p. 1772
- Townsend (2001) Sabiston Surgery, Saunders, p. 547
- Hong (1999) J Laryngol Otol 113(11):1031-3 [PubMed]
- Mandell (2000) Otolaryngol Clin North Am 33(6):1309-32 [PubMed]
- Palacios (2001) Ear Nose Throat J 80(5):302 [PubMed]