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What is a Branchial Cleft Cyst?

Deanna Baranyi
Updated Jan 24, 2024
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A branchial cleft cyst, also known as a cleft sinus, is a birth defect that appears on the sides of the neck or below the collarbone. It occurs when the embryonic tissues of the collarbone and neck areas do not develop in a normal fashion. There is usually a lesion that is formed that is similar to slits found in the gills in fish; this is where the cyst forms. It can collect drainage fluid from the sinuses that make it prone to infection. Although the cyst forms during the embryonic stage, it may not be noticed until early adulthood.

In many cases, a branchial cleft cyst will not present any symptoms. It can manifest itself as a small lump, a pit, or a skin tag on either side of the neck or beneath the collarbone area. If a pit is formed, fluid from the sinuses may drain from it. Sometimes the cyst may become tender to the touch, while at other times, it can become inflamed, enlarged, or even become abscessed, if the affected person suffers from an upper respiratory tract infection. If the lump is large, symptoms may include difficulty swallowing, difficulty breathing, or hoarseness.

There are two different kinds of branchial cleft cyst lesions: primary and secondary. The primary lesion is smooth and not tender to the touch, while the secondary is tender, especially if it is infected. If the cyst becomes infected, it must be treated with antibiotics immediately.

Besides treating the associated infection with a round of antibiotics, one way to cure a person affected with this birth defect is surgery. Usually, a surgeon will perform a set of horizontal incisions to remove the cyst. Surgery is not recommended for patients under the age of three months, although there are always medical exceptions. If the person is suffering from a severe infection or an abscess, surgery should not be performed until the infection or abscess has cleared up.

In some cases, surgery is insufficient and other forms of treatment are needed. A few people have opted for sclerotherapy, a treatment more commonly used for varicose veins. When used on a branchial cleft cyst, the fluid in the cyst is drained. Then, the cyst is injected with medication called a sclerosing agent, specifically OK-432. According to research, the cyst will disappear completely in nearly half of cases.

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Deanna Baranyi
By Deanna Baranyi
Deanna Baranyi, a freelance writer and editor with a passion for the written word, brings a diverse skill set to her work. With degrees in relevant fields and a keen ability to understand and connect with target audiences, she crafts compelling copy, articles, and content that inform and engage readers.
Discussion Comments
By anon290925 — On Sep 11, 2012

I have just been diagnosed with a branchial cleft cyst sitting on top of a very inflamed lymph node. I have a constant feeling of phlegm running down my throat, my ear hurts and and I get a lot of headaches and feel tired all the time. I am 32. The doc said it's slightly inflamed and the cyst itself is 3.7cm so it's quite a big one.

It was diagnosed through a core biopsy. I find it odd it's a birth defect and mine has only developed and grown the last eight months. I am booked in to see a surgeon. My doctor was surprised at the biopsy results. He was testing for lymphoma, however he said he wasn't surprised it wasn't lymphoma, but that was just a precaution. He was very very surprised it was a branchial cleft cyst though. Can they ever be misdiagnosed through a core biopsy and in fact be something else? Also can they make you ill/feel ill?

By galen84basc — On Nov 12, 2010

Could you tell me a little more about branchial cleft cyst removal? My daughter has recently started showing branchial cleft cyst symptoms, and we're considering treatment options.

Though aspiration is the easiest, it seems like sclerotherapy might be a better option, since it has more of a chance of being permanent.

What do you think?

By pharmchick78 — On Nov 12, 2010

Did you know that there's a similar condition to a branchial cleft cyst called a thyroglossal duct cyst?

Much like the branchial cleft cyst pathology, a thyroglossal duct cyst shows up as a lump on the neck that can be hard, but is usually painless, just like a branchial cleft cyst.

The main difference between branchial cleft cysts and thyroglossal duct cysts is the placement. Whereas the branchial cleft cysts show up on the side of the neck, a thyroglossal duct cyst shows up on the front of the neck, almost like an extra Adam's apple.

Although thyroglossal duct cysts are often not dangerous (again like branchial cleft cysts), they can be uncomfortable, especially for women who feel awkward having a visible lump on the front of their neck. Also, the cyst will be removed if it becomes chronically infected, since it does tend to catch the drainage of the sinuses, just like the branchial cleft cyst.

The treatment is usually the same -- just draining, and excision if need be. Isn't it interesting how different parts of the body can experience the same thing?

By Planch — On Nov 12, 2010

What would be some of the other branchial cleft cyst symptoms? I have recently started to experience what my doctor calls a "submandibular swelling," and although he said it was nothing to worry about, I started looking around at webMD and sites like that, and found out about a branchial cleft cyst.

Would it be possible to have one of those things without knowing if for years on end? Because I am in my late thirties and I'm just now experiencing the swelling.

Do you think it could possibly be a branchial cleft cyst, or am I just over-analyzing and worrying to much?

Deanna Baranyi
Deanna Baranyi
Deanna Baranyi, a freelance writer and editor with a passion for the written word, brings a diverse skill set to her...
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