Branchial Cleft Cyst

1. Type 2 First Branchial Cleft anomaly

1.1. ectodermal & mesodermal derived tissue

1.2. below angle of mandible. pass thru parotid g. close prox to facial n.

1.3. end either inferior to or into external auditory canal @ bone cartilage junction

2. 2nd Branchial Cleft Anomalies

2.1. most common of the 3 types

2.2. discrete round mass

2.3. below mandible angle @ SCM border

2.4. potential tract->associated sinus->deep to 2nd arch & superficial to 3rd arch derivatives opening in tonsillar fossa

3. failure of pharyngobrachial tissues to obliterate during fetal growth

4. classified as 1st,2nd, or 3rd

5. located @ SCM border

6. Treatment of BCC

6.1. control infection!

6.2. Surgical excision of cyst & tract

6.3. I&D should be avoided/may be necessary for acute abscess tx

6.4. needle aspiration & decompression beneficial to prevent I&D

7. 1st Branchial Cleft Anomalies

7.1. < 1% of branchial anomalies

7.2. usually face or aurical

7.3. type 1 or type 2

8. Type 1 first Branchial Cleft Anomaly

8.1. duplication anomaly of external canal

8.2. ectodermal derived tissues

8.3. may pass into parotid gland& close to facial n.

9. present in late childhood/early adulthood

10. tender, inflammatory mass

11. 3rd Branchial Cleft anomalies

11.1. anterior to SCM & lower in neck than 1st & 2nd

11.2. located deep to 3rd arch derivatives & superficial to 4th arch derivatives.

11.3. Ends in pharynx @ thyroid membrane or pyriformus sinus