Branchial cleft cyst

Branchial cleft cyst
Classification and external resources

Fistulography of a right branchial cleft sinus.
ICD-10 Q18.0 (ILDS Q18.020)
OMIM 113600
DiseasesDB 1588
MedlinePlus 001396
eMedicine derm/61 radio/107

A branchial cleft cyst (also known as "Pharyngeal fistula" or "Branchial cyst"[1]:782) is an oval, moderately movable cystic mass that develops under the skin in the neck between the sternocleidomastoid muscle and the pharynx.

Contents

Pathology

The cyst wall will be composed of either squamous or columnar cells with lymphoid infiltrate, often with prominent germinal centers. The cyst may contain granular and keratinaceous cellular debris. Cholesterol crystals may be found in the fluid extracted from a branchial cyst.

Pathophysiology

Branchial cleft cysts are remnants of embryonic development and result from a failure of obliteration of the branchial cleft, which in fish develop into gills.[2][3]

Types

  • First branchial cleft cysts typically originate in the angle of the mandible and extend to the external auditory canal. They are often associated with the facial nerve.
  • Second branchial cleft cysts are most common. They are found along the anterior border of the Sternocleidomastoid_muscle, passes through the carotid bifurcation and into the tonsillar pillar.
  • Third branchial cleft cysts are rare and found in the lateral neck.

Symptoms

Most branchial cleft cysts are asymptomatic, but they may become infected.

Treatment

Bilateral branchial cleft sinuses during surgery.

Conservative (i.e. no treatment), or surgical excision. As complete surgical excision may be difficult (due to the close proximity of the internal jugular vein and carotid vessels that lie deep to the swelling), they can recur.[4]

See also

References

  1. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0071380760.
  2. ^ Hong, Chih-ho. Branchial cleft cyst. eMedicine.com. URL: http://www.emedicine.com/derm/topic61.htm. Accessed on: August 24, 2008.
  3. ^ Shubin, Neil "Your Inner Fish" 2009
  4. ^ Waldhausen JH (May 2006). "Branchial cleft and arch anomalies in children". Seminars in pediatric surgery 15 (2): 64–9. doi:10.1053/j.sempedsurg.2006.02.002. PMID 16616308. 

External links


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