Branchial Cleft Cyst

Branchial cleft cyst is a kind of birth defect. It is described as a remnant which is derived from the fusion planes lying between the developing neck and head. Under normal circumstances, these fusion planes blot out. They sometimes persist as a potential space which can be filled with fluids, prone to infection.

It appears as small pits, skin tags, or lumps which are present on either side of the neck or right under the collarbone. The cyst may become enlarged, inflamed, or abscessed if the person suffers from some sort of ailment of the upper respiratory tract. The lump sometimes enlarges to such an extent that it causes difficulty in swallowing, troublesome breathing and hoarseness of voice. When the branchial cleft cyst symptoms are severe, fluid drainage from the pit on the neck is observed. This is a condition of medical emergency.

Branchial Cleft Cyst Causes

As has already been mentioned, branchial cleft cysts form during the stages of embryonic development. They happen to occur when the tissues in the neck and collarbone area, also known as branchial cleft, fail to develop as it does in normal cases. They appear as open spaces on either or both sides of the neck. These open spaces are called cleft sinuses. The branchial cleft cysts may form from the fluid drained from a sinus. The cyst and sinus can get infected with micro-organisms.

Branchial Cleft Cyst Types

There are basically two types of branchial cleft cysts, primary and secondary. They are grouped in accordance with their embryologic derivation. The primary type of branchial cleft cysts are found in the preauricular area. They are not painful to the touch. The secondary type of the branchial cleft cysts are present anywhere along the anterior margin of the sternocleidomastoid muscle. They are tender, particularly when they are infected. The infected branchial cleft cysts must be treated with antibiotics immediately.

Branchial Cleft Cyst Diagnosis

The diagnosis of branchial cleft cysts takes the medical history, physical examination and ancillary tests into consideration. The cysts can develop and show its presence at any age. In majority of the cases, they are found to occur in childhood or early adulthood. They are often found to be associated with urinary tract infections. They generally increase in size over a period of 7-14 days. They can spontaneously fall back or persist. Quite commonly, they become infected, painful and cause drainage through the skin.

The doctor inquires about urinary tract disorders and hearing problems as branchial cleft cysts can be expressions of Branchio-Oto-Renal syndrome. The doctor also focuses on any kind of rise in the risk for head and neck malignancies. The branchial cleft cysts are soft, non-tender and mobile masses. They may be linked to a small skin pit. They give rise to skin discoloration only when infected. The doctor conducts the physical examination of the branchial cleft cysts to rule out other reasons behind the occurrence of the mass in the neck. The ultrasound test can confirm the presence of branchial cleft cysts, hence it is necessary to be done.

Branchial Cleft Cyst Treatment

In case of absence of symptoms, the otolaryngologist keeps the patient under observation for 10-12 days. This allows him to collect sufficient data about the neck mass. The patients with suspected branchial cleft cysts, which show the symptoms and do not regress in 7-10 days, are brought either under specialty medical care to head and neck surgery or to general operation. When the branchial cleft cysts are infected, they are cured with a round of antibiotics. However, the definitive management of such a neck mass is complete surgical removal. It can be performed only when the infection has been treated completely. The surgery involves a set of horizontal incisions to take out the cyst. Surgical treatment is not recommended for patients who are under the age of three months. Fortunately, such cases are rare.

There are a few cases reported to have shown failure of surgery to treat branchial cleft cysts. Such patients have to undergo sclerotherapy, a type of cosmetic therapy, with a specific sclerosing agent, OK-432. It involves complete removal of fluid from the cyst, followed by the injection of the sclerosing agent. This results in disappearance of the cyst.

The branchial cleft cysts are prone to infections. This aggravates the discomfort and uneasiness caused by the cyst. Therefore, if you notice the symptoms in your neck or collarbone, you need to immediately book an appointment with an otolaryngologist. Timely medical intervention will treat the branchial cleft cysts effectively.