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Excision of Branchial Cleft Cysts in Tampa and Spring Hill, FL

A mass on the side of your neck may interfere with breathing and swallowing. For many patients in Tampa, Spring Hill and nearby areas in Florida, the masses are branchial cleft cysts that are removed through surgery. The board-certified Otolaryngologist/Head and Neck Surgeons of Suncoast ENT Surgical Specialists provide you with the professional guidance you need when considering excision of branchial cleft cysts.

What Are Branchial Cleft Cysts?

A branchial cleft cyst is a skin-lined cavity that is filled with mucus that forms on the side of your neck. The abnormality is congenital, which means that it occurs during fetal development. Branchial arches are gill-like embryonic structures that normally disappear as part of fetal development. In some cases, though, the arches fail to disappear and may cause cysts later in life. The fluid-filled pouch that is left may not be noticeable for years and increases the risk for infection.

Symptoms And Types

Branchial cleft cysts often appear during childhood and young adulthood as painless, slow-growing masses, which are generally the chief complaint. As the cysts enlarge or become infected, they can cause breathlessness and trouble swallowing. In 2% of cases, cysts appear on both sides of the neck.

Our ENT specialists identify your cyst as one of the four types, each of which is named for the associated branchial arches. First branchial cleft abscesses are split into two types. Type I first branchial cleft abnormalities rarely occur and represent a copy of the external ear canal. They can develop near the facial nerve, which controls movements of the face. Type II first branchial cleft cysts occur more often and appear as masses right below where the jaw begins to angle. Type II cysts could have a tubular structure that passes through the parotid gland, a large salivary gland on the face that is closely related to the facial nerve. The structure may end in or at the external ear canal.

Second branchial cleft abscesses happen the most often out of the four types and could involve painless masses under the jawline and under or in front of the sternocleidomastoid, which is a large neck muscle. Third branchial cleft cysts are rare masses that may occur in the lower lateral neck, and fourth branchial cleft abscesses are rare masses that might drain into the throat.

Sometimes an emergency incision is required to control and drain the infection that arises in branchial cleft cysts that create breathing and swallowing problems. However, this can cause extra scarring and make it more challenging for a surgeon to perform definitive surgery at a later date. When the surgery is eventually performed, it is important that the deep tubular remnants of the cyst that appear around the facial nerve and other structures in the neck are removed to prevent the abscesses from forming again.

Purpose of the Procedure

Excision of branchial cleft cysts is performed to remove the mass that may be related to a drainage site through the skin.

Excision of Branchial Cleft Cysts Procedure

During the procedure, the surgeon makes an incision in the skin that covers the mass and then carefully separates the cyst from the surrounding tissue. These tissues include the external and internal carotid arteries as well as the nerves that control tongue movement and the nerves that help with swallowing. Then, the surgeon cuts the attachment and removes the mass. If it is necessary, the opening into the throat will be closed. Sutures and electrocautery are used to control bleeding during and after the procedure. A temporary drain is fitted to the surgical site, and the surgeon closes the incision in the neck with removable and dissolvable sutures.

Post Procedure

After the procedure, the dressing needs to be changed for one or two days until the surgical site is producing only minimal drainage. Then, the drain is removed, and the dressing is reapplied for one more day. Patients should avoid water exposure for about one week until the sutures are removed.

A codeine type of pain medication will be prescribed to relieve discomfort during the recovery process. Since it can cause drowsiness, operating machinery or a motor vehicle is not permitted while taking the medication. Daily activities such as school and work cannot resume until the medication is no longer needed during the day.

Branchial arches typically disappear during fetal development, but in some cases, the arches remain in the body after birth. Over time, fluid collects in the area which can lead to infection. If you have a mass on one or both sides of your neck, we recommend that you contact our office in Tampa or Spring Hill to determine if excision for branchial cleft cysts is recommended for you.