Excision of Branchial Cleft Cyst

Excision of Branchial Cyst is a surgical procedure to remove Branchial Cyst, also called branchial cleft remnants or branchial cleft anomalies.

May 23, 2022

Excision of Branchial Cyst is a surgical procedure to remove Branchial Cyst, also called branchial cleft remnants or branchial cleft anomalies.

Some facts about Excision of Branchial Cleft Cyst: 

  • Branchial Cleft Cyst are a congenital condition in which tissue develops incorrectly on one or both sides of the neck.
  • Branchial cleft cysts are small sacs filled with fluid that may look like lumps under your skin on the side of your neck.
  • A collection of fluid forms when there is no external opening and liquid cannot drain out of the neck causing Branchial Cleft Cyst.
  • Sometimes, these have openings on the inside or outside of the skin called sinus tracts.
  • Branchial cleft cysts can appear at any age but are typically found in children.
  • Surgery is recommended to remove the cyst, although they are benign.
  • Branchial cleft cysts are referred as pharyngeal cleft cysts or as a type of neck mass.
  • Noticeable branchial cleft cysts can develop later in life which usually happens when the cysts are infected.
  • There is a chance of recur, or come back of the cyst, after being surgically removed. 
  • There are 4 types of branchial cleft cysts including first, second, third and fourth branchial cleft cysts.
  • Partial thyroidectomies is recommended if you have third or fourth branchial cleft cysts that affect your thyroid.

Diagnosis of Branchial Cleft Cyst: 

  • Your neck will be examined and you will be asked about your symptoms to diagnose Branchial Cleft Cyst.
  • Computed tomography (CT), Magnetic resonance imaging (MRI), Chest X-ray, Ultrasound and Hearing examination will be conducted to diagnose Branchial Cleft Cyst.
  • Surgery is recommended to remove your cyst even if your cleft cyst isn't causing problems to eliminate the chance of your cyst becoming infected.

Procedure for Excision of Branchial Cleft Cyst:

  • Complete surgical excision may be difficult due to the close proximity of the internal jugular vein and carotid vessels that lie deep to these anomalies.
  • However, these can recur if incompletely excised.
  • Definitive branchial cleft surgery is avoided if an abscess is present or during an episode of acute infection.
  • General anesthesia will be used for surgery.
  • The occasionally tortuous path of the branchial cleft anomaly will be disected out by making more than one horizontal incision, known as a stairstep or stepladder incisions.
  • Endoscopic visualization through the mouth may be needed for complete removal of the tract remnant when the branchial cleft anomaly tract extends into the back of the throat also called the pharynx.
  • Tonsillectomy is also included if the tract extends into the tonsillar bed.
  • Patients may go home the same day or have to stay overnight depending on the size and location of the lesion, as well the type of surgery.
  • A small drain will be placed in the wound and kept in place for 1 to 2 days.
  • The patient will probably have some discomfort after the surgery for which pain medicine is usually prescribed.
  • Stitches will be removed a week after surgery is required.
  • Usually, recovery takes about a week.
  • A follow‐up appointment is typically made about 1 to 2 weeks after the surgery to check how the area is healing.