What is a branchial cyst?
It is a congenital defect that arises during early embryonic development when the structures and tissues forming the neck do not develop properly together. These tissues subsequently form fluid-filled sacs. This fluid-filled lump is called a branchial cyst. Although it is present from childhood, it is often noticed in adulthood. This mass usually appears as an asymptomatic lump on either the left or right side of the neck, anywhere from the jaw to the collarbone. Sometimes, the fluid in the cyst can become infected, leading to the sudden appearance of a tender neck mass.
Symptoms caused by the condition
A branchial cyst is an embryonic remnant that exists from birth but may remain asymptomatic for a long time. It typically becomes noticeable when it increases in size, presenting as a soft, painless mass on the lateral side of the neck. In most cases, the cyst is detected during adolescence or adulthood and may cause cosmetic concerns.
Often, the increase in its size is associated with an upper respiratory infection, such as tonsillitis or pharyngitis. If the cyst becomes infected with microorganisms, it may become inflamed, swell, and cause severe pain. In more serious cases, an abscess filled with pus may form, which may either drain spontaneously through the skin or require surgical drainage.
Diagnosis of the condition
Diagnosis of a branchial cyst is primarily based on clinical examination by a specialized ENT surgeon, who can detect and palpate the mass on the side of the neck. To confirm the diagnosis and accurately map the cyst, additional imaging tests such as ultrasound, MRI, or CT scan are performed. These tests help differentiate the branchial cyst from other neck masses.
In rare cases where malignancy is suspected, a fine-needle aspiration (FNA) biopsy may be performed, although this is usually avoided due to the risk of infection and the generally benign nature of the cyst.
Recommended treatment for a branchial cyst
Definitive treatment for a branchial cyst is surgical removal. The procedure is performed under general anesthesia through a small horizontal incision in the lateral neck area. For cosmetic reasons, the incision is closed using plastic surgery techniques to ensure it is as discreet as possible.
In cases where the cyst is infected and contains pus, surgical drainage is first performed along with antibiotic treatment. Once the inflammation subsides, surgical removal of the cyst can be scheduled to prevent recurrence.
Postoperative recovery period
After the surgery, the patient returns home the following day. In some cases, a drain is placed, which is removed before discharge from the hospital. During the first few days, antibiotics and mild painkillers are prescribed to relieve discomfort. The stitches are removed in about a week, and the patient can resume daily activities without restrictions.
Overall, a branchial cyst is a benign congenital condition that generally does not cause issues unless it enlarges or becomes infected. With proper treatment and guidance from a specialist, patients can be freed from the condition and avoid potential future complications. ENT Surgeon in Athens Dr. Olga Papadopoulou performs surgical treatment of branchial cysts when deemed necessary to prevent the development of future issues.