General Surgery
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
How would you treat a branchial cleft cyst?Make a careful surgical excision.The first cleft opens at the angle of the mandible and passes through branches of the facial nerve.The second cleft (most common) opens at the anterior border of sternocleidomastoid (SCM) between carotid bifurcation.The third cleft opens at the lower border of SCM and passes behind the carotid artery.
Branchial cleft cysts
Alisa McQueen, S. Margaret Paik in Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
This is a branchial cleft cyst. Branchial cleft anomalies may present as a cyst, sinus, fistula, or cartilaginous remnant. The majority are cystic structures arising from the region of the second branchial arch. Most present in the first or second decade of life but some are noted at birth. A branchial cleft cyst is usually located superior to the clavicle, along the anterior border of the sternocleidomastoid muscle and presents as a painless, mobile, fluctuant mass. The differential diagnosis includes cervical lymphadenopathy, dermoid cyst, and cystic hygroma fibrous dysplasia of the sternocleidomastoid muscle. A thyroglossal duct cyst will present in the midline or paramidline at or below the level of the hyoid bone.
Test Paper 6
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
MR imaging better depicts the deep tissue extent of a second branchial cleft cyst, which allows accurate preoperative planning. The cyst fluid varies from hypointense to slightly hyperintense relative to muscle on T1-weighted images and is usually hyperintense on T2-weighted images. Mural thickness and enhancement vary, depending of the presence and severity of any associated inflammatory process. Occasionally, a ‘beak sign’ may be seen on axial CT or MR images. This sign represents a curved rim of tissue or ‘beak’ pointing medially between the internal and external carotid arteries. It is considered a pathognomonic imaging feature of a second branchial cleft cyst.
Prevalence of cystic metastases in a consecutive cohort of surgically removed branchial cleft cysts
Published in Acta Oto-Laryngologica, 2022
Lalle Hammarstedt Nordenvall, Evelina Jörtsö, Mathias von Beckerath, Edneia Tani, Sushma Nordemar, Rusana Bark
A retrospective analysis was performed where patients were identified with NOMESCO surgical procedure code ENB40 (Excision of lateral branchial cleft cyst- or fistula) in the ORBIT® operation booking system (WM-data, Stockholm, Sweden). These patients had all undergone surgical treatment for BrCC beginning 1 December 2003 and ending 31 December 2019. The data from the patients’ charts were extracted from the Karolinska’s electronic patient medical record, TakeCare®. Medical record review was then performed with follow-up ending 21 January 2020. Patient records were obtained and all patients with pre-operative diagnosis of BrCC were included in the study. After reviewing the medical records of all 586 patients, 436 patients had undergone surgery based on an initial diagnosis of branchial cleft cyst and were included for final analysis (Figure 1). Altogether, 150 patients were excluded because they had other diagnosis than BrCC, such as thyroglossal neck cysts and neck fistulas, as well as incorrectly coded surgeries such as lipomas and parotid tumour (Table 1).
Cranial dermoid cyst with long-term development treated by ethanol sclerotherapy: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Takeshi Kitazawa, Masato Shiba, Hiroyuki Nagaya, Shunsuke Yuzuriha
Ethanol sclerotherapy is widely performed for cystic masses. Baker’s cyst, branchial cleft cyst, thyroglossal duct cyst [8], and seroma [9] have reportedly been treated successfully using this method. Ethanol causes inflammatory reactions involving endothelial cells of the cyst wall, leading to fibrosis and cyst closure. Sclerotherapy using absolute ethanol has the benefit of technical simplicity and low cost compared to other sclerosants [10].
Lateral neck cyst as initial presentation of thyroid malignancy
Published in Acta Chirurgica Belgica, 2020
Lieze Vancraeynest, Sam Van Slycke
A mass in the lateral aspect of the neck may cause a diagnostic dilemma for the clinician. Cystic lateral neck masses in young adults are most often benign as the most frequent cause is a branchial cleft cyst. Branchial cleft cysts typically arise from the second branchial cleft and are mostly localized anterior of the sternocleidomastoid muscle. It most frequently becomes symptomatic in the second or third decades of life [2].
Related Knowledge Centers
- Birth Defect
- Cyst
- Pharyngeal Arch
- Sternocleidomastoid Muscle
- Upper Respiratory Tract Infection
- Infection
- Fistula
- Pharyngeal Groove
- Asymptomatic
- Animal Embryonic Development