Branchial cleft cyst
Cleft sinus
A branchial cleft cyst is a birth defect. It is caused when fluid fills a space, or sinus, left in the neck when a baby develops in the womb. After the baby is born, it appears as a lump in the neck or just below the jawbone.
Causes
Branchial cleft cysts form during development of the embryo. They occur when tissues in the neck area (branchial cleft) fail to develop normally.
The birth defect may appear as open spaces called cleft sinuses, which may develop on one or both sides of the neck. A branchial cleft cyst may form due to fluid in a sinus. The cyst or sinus can become infected.
Symptoms
The cysts are most often seen in children. In some cases, they are not seen until adulthood.
Symptoms may include any of the following:
- Small pits, lumps, or skin tags at either side of the neck or just below the jawbone
- Fluid drainage from a pit on the neck
- Noisy breathing (if the cyst is large enough to block part of the airway)
Exams and Tests
The health care provider may be able to diagnose this condition during a physical examination. The following tests may be done:
- CT scan
- MRI scan
- Ultrasound
Treatment
Antibiotics will be given if the cyst or sinuses are infected.
Surgery is generally needed to remove a branchial cleft cyst in order to prevent complications such as infections. If there is an infection when the cyst is found, surgery will likely be done after the infection has been treated with antibiotics. If there have been several infections before the cyst is found, it may be harder to remove.
Outlook (Prognosis)
Surgery is usually successful, with good results.
Possible Complications
The cyst or sinuses may become infected if not removed. Repeated infections may make surgical removal more difficult.
When to Contact a Medical Professional
Contact your provider for an appointment if you notice a small pit, cleft, or lump in your child's neck or upper shoulder, especially if fluid drains from this area.
References
Loveless TP, Altay MA, Wang Z, Baur DA. Management of branchial cleft cysts, sinuses, and fistulae. In: Kademani D, Tiwana PS, eds. Atlas of Oral and Maxillofacial Surgery. St Louis, MO: Elsevier Saunders; 2016:chap 92.
Thatcher AL. Congenital and inflammatory neck masses in children. In: Lesperance MM, eds. Cummings Pediatric Otolaryngology. Philadelphia, PA: Elsevier; 2022:chap 23.
Version Info
Last reviewed on: 11/9/2021
Reviewed by: Kimberly G. Lee, MD, MSc, IBCLC, Clinical Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
