• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.94-97
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• 2018

Background and Objectives : Fourth branchial cleft cyst is a rare congenital anomaly which cause a recurrent cervical abscess. Complete excision of fourth branchial cleft cyst is difficult because of a complicated fistula tract. In addition to attempting chemocauterization with trichloroacetic acid (TCA) to avoid surgical complications, authors performed an electrocauterization to close internal opening of pyriform sinus. Materials and Methods : We reviewed ten patients of fourth branchial cleft cyst underwent TCA chemocauterization and electrocauterization simultaneously. Clinical characteristics including patient informations, medical records, treatment results were analyzed retrospectively. Results : Interval time until diagnosed with fourth branchial cleft cyst was variable from several days to decades. Five patients had a history of incision and drainage. Mean follow up period was 36.1 months and all patients were treated with no recurrence. Conclusion : TCA chemocauterization with electrocauterization can be a effective choice to reduce recurrence rate and ensure safety of patients of fourth branchial cleft cyst.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.63-66
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• 2003

Branchial cleft cysts typically are characterized as lateral swellings anterior to sternocleidomastoid muscle in upper third of the neck. However, cysts have been reported in unusual location such as the thymus, oral cavity, parotid gland, pancreas, and thyroid. Perithyroidal branchial cleft cysts are also rare and preoperative diagnosis is very difficult. Recently we have experienced a case of intrathyroidal branchial cleft cys and a case of perithyroidal branchial cleft cyst, which were diagnosed preoperatively as the parathyroid cyst. So, we report these two cases with review of the literatures.

• Korean Journal of Head & Neck Oncology
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• v.21 no.1
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• pp.53-56
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• 2005

The branchial anomaly is a lateral neck mass commonly seen by otolaryngologists. Depending on its anatomic location, branchial anomaly can be classified into first, second, third and fourth. The fourth branchial cleft anomaly is very rare entity and until now, only 35cases have been reported worldwide. It may present as neck cyst, recurrent neck abscess, thyroiditis. Combined with barium swallow esophagogram and computed tomography scan can aid in diagnosis of this rare disease entity. Complete excision of the entire epithelial tract combined with ipsilateral thyroid lobectomy remains the mainstay of treatment. Authors experienced a case of lateral neck mass which was anatomically presumed to be the fourth branchial cleft cyst. We report this case with the related literature.

• Korean Journal of Bronchoesophagology
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• v.18 no.2
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• pp.60-63
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• 2012

Second branchial cleft cysts are usually present as a fluctuant neck mass along the anterior border of the sternocleidomastoid muscle. When they are found in this typical location, accurate diagnosis on initial presentation is not difficult. Parapharyngeal presence of the branchial cleft cyst is very rare. We report a case of second branchial cleft cyst presenting as a parapharyngeal cystic mass in 51-year-old male. Before coming to our clinic, the patient had been diagnosed as parapharyngeal abscess, resulting in several attempts at removal. However, symptoms and parapharyngeal abscess recurred. We performed complete surgical resection of the parapharyngeal cystic mass via transoral approach only with oropharyngeal incision. The cystic mass was located in the parapharyngeal space and did not have tract-like structure. Histopathologic examination confirmed that the excised cyst was branchial cleft cyst. Patient discharged without any surgical complication and there was no evidence of recurrence for 2 years follow-up.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.180-186
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• 1990

This is a case report of first branchial cleft cyst in 56 year old male patient, which was tentatively diagnosed as acute right submandibular abscess resulted from the periapical lesion of the lower right second molar. The results are as follows, 1. The accompanying ipsilateral inflammatory swelling resulted from the periapical lesion of lower right second molar tooth makes the diagnosis difficult. 2. The onset of this case was very late in comparison to the mean discovering age of branchial cleft cysts. 3. The plain radiography using contrast media is helpful for the diagnosis of cystic lesions within soft tissues. 4. This case in a first branchial cleft cyst(Type I) which occurs less than 1% of all branchial cleft anomalies.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.2
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• pp.365-372
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• 1993

Branchial cleft cyst is the most common lateral neck cyst; the vast majority are of the second branchial cleft origin. This presumably reflects the greater depth and longer persistence of the second cleft, compared with the first, third, and fourth clefts. We experienced a 49-year-old male whose chief complaint was a abnormal mass of the left parotid gland area and neck. As a result of careful analysis of clinical, radiological, and histopathological findings, we diagnosed it as a second branchial cleft cyst in the neck and obtained results as follows: 1. In clinical examination, there was a 10×15㎝ sized, fluctuant painful mass in the left neck and parotid area. 2. In radiographic examination, a low echogenic mass with internal cystic change in the inferior parotid gland area was noted sonographically. Computed tomograph showed a 3×4㎝ sized, well-defined cystic mass with heterogenous solid component in the anterior border of sternocleidomastoid muscle. MRI revealed 5×6㎝ sized, well-marginated multi separated mass in the same area. 3. In histopathological examination, lining of cyst was stratified squamous epithelium with typical lymph node pattern and inflammatory cell infiltration.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.86-90
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• 2015

Cystic lymph node metastasis of head and neck squamous cell carcinoma(HNSCC) which presumed to be mainly originated from oropharynx including Waldeyer's ring may present as a benign cystic mass on lateral neck such as branchial cleft cyst. Branchial cleft cyst is one of the most common lateral neck cystic mass which may result in regional infection or lymph adenopathy. Many of previously reported literatures showed the incidence of cystic lymph node metastasis from oropharynx including Waldeyer's ring. Preoperative imaging studies and fine needle aspiration cytology cannot provide the accurate results until excision of cystic mass for the diagnostic or therapeutic purpose. Recently, we experienced the rare case of cystic lymph node metastasis from ipsilateral tonsil, which mimicked infected 2nd branchial cleft cyst. Thus, we reported our experience with presentation of case and review of literatures.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.1005-1009
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• 2006

A rare case is described of an intrathyroidal branchial cleft-like cyst in neonate. The patient was a newborn girl with a mass in the left lateral neck. The ultrasonography and computed tomography revealed a cystic lesion in the left thyroid. The lesion was enucleated surgically from the thyroid. Histologically, the cyst was lined by squamous or columnar epithelium and contained inflammatory cell infiltraion, thyroid and parathyroid tissue. The patient has been doing well without any evidence of thyroid dysfunction for 15 months.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.56-62
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• 1995

Branchial cleft cyst is rarely encountered congenital neck disease. It is commonly believed that the branchial anomaly is persistance of remnant of the embryologic branchial apparatus. Among the patients visited Kyung Hee Medical Center with neck mass and inflammatory sign from January, 1980 to Aprial, 1994, we reviewed 26 cases of branchial cleft cysts confirmed by histopathologic findings with retrospective study on clinical aspects. The results are as follows: 1) There was no sex difference(14 male and 12 female), and most common between 2nd and 4th decade(21 cases, 80%). 2) Palpable mass was most common complaint(21 cases). In physical exam, the mass was non-tender, mobile and soft in most cases(over 80%). 3) The most common lesion site was anterior triangle in 15 cases. Along the SCM level, 21 cases were in upper 1/3, 2 cases in middle 1/3 and 3 cases in lower 1/3. 4) According to Bailey's classification, type II were 20 cases(76.9%), type I 5 cases(19.2%) and type III 1 case. 5) Among 28 cases, fistulous tract was found in 6 cases: one was complete type and 5 were incomplete type. 6) Among 26 cases before operation, 10 cases were diagnosed as branchial cleft cyst, 6 cases tuberculosis, 3 cases parotid tumor and 2 cases thyroglossal duct cyst. 7) Type of lining epithelium in histopathologic finding was stratified squamous epithelium in 22 cases(84.6%), mixed type in 4 cases(15.4%).

• Korean Journal of Bronchoesophagology
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• v.8 no.2
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• pp.43-46
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• 2002

Branchial cleft cysts are most common neck masses in adults. Most are second branchial cysts, which occur in the neck, anterior to sternocleidomastoid muscle at the mandibular angle. Rarely these cysts may be present in the parapharyngeal space. We report a case of a second branchial cleft cysts in the parapharyngeal space of 32-year-old female, which was misdiagnosed as peritonsillar abscess. It was excised via transoral and transcervical approach.