CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2020; 24(03): e347-e350
DOI: 10.1055/s-0039-1695023
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Branchial Cysts in Quito, Ecuador

1   Department of Surgery, Centro Médico Oncológico, Quito, Pichincha, Ecuador
Andrés Ayala-Ochoa
2   Department of Surgery, Hospital Vozandes Quito, Quito, Pichincha, Ecuador
Karla Salvador
3   Department of Otorhinolaryngology, Hospital de Ninos Baca Ortiz, Quito, Pichincha, Ecuador
› Author Affiliations
Further Information

Publication History

21 February 2018

20 June 2019

Publication Date:
09 January 2020 (online)


Introduction Branchial cleft anomalies are the second most common congenital anomaly in children. However, some lesions may not develop clinically and are not diagnosed until adulthood. The recent literature of branchial cysts (BCs) in the adult population is really scanty. For this reason, we analyzed the clinical and surgical management of the adult population treated for a BC at a tertiary care general hospital.

Methods A retrospective review of the clinical records of all the patients with histological diagnosis of BC who were surgically treated at the Social Security Hospital in Quito, Ecuador, was performed. Fifty-one patients (27 women) with congenital anomalies of the 2nd (43 patients with cysts) and 3rd (6 patients with cysts and 2 with fistula) branchial arches were diagnosed and treated. Diagnosis was made on clinical grounds and by computed tomography scan.

Results The 43 patients with a 2nd branchial cleft cyst underwent complete surgical excision through a wide mid-neck transverse cervicotomy. The 6 cases of 3rd branchial cleft cyst underwent surgical resection through a lower-neck transverse incision, and the 2 patients with clinical fistula in the lower aspect of the neck were operated on via an elliptical incision around this external fistula opening. Postoperative evolution was uneventful in all patients.

Conclusions Branchial cysts can occasionally be diagnosed in adult patients in the setting of a general hospital population. A correct clinical and imaging assessment was diagnostic in most patients. Complete surgical resection was curative in all our patients, and postoperative complications were exceptional.

  • References

  • 1 Goff CJ, Allred C, Glade RS. Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (06) 533-539 . Doi: 10.1097/MOO.0b013e32835873fb
  • 2 Bajaj Y, Tweedie D, Ifeacho S, Hewitt R, Hartley BE. Surgical technique for excision of first branchial cleft anomalies: how we do it. Clin Otolaryngol 2011; 36 (04) 371-374 . Doi: 10.1111/j.1749-4486.2011.02312.x
  • 3 Glosser JW, Pires CA, Feinberg SE. Branchial cleft or cervical lymphoepithelial cysts: etiology and management. J Am Dent Assoc 2003; 134 (01) 81-86
  • 4 Guldfred LA, Philipsen BB, Siim C. Branchial cleft anomalies: accuracy of pre-operative diagnosis, clinical presentation and management. J Laryngol Otol 2012; 126 (06) 598-604 . Doi: 10.1017/S0022215112000473
  • 5 Kenealy JF, Torsiglieri Jr AJ, Tom LW. Branchial cleft anomalies: a five-year retrospective review. Trans Pa Acad Ophthalmol Otolaryngol 1990; 42: 1022-1025
  • 6 Daoud FS. Branchial cyst: an often forgotten diagnosis. Asian J Surg 2005; 28 (03) 174-178
  • 7 Golledge J, Ellis H. The aetiology of lateral cervical (branchial) cysts: past and present theories. J Laryngol Otol 1994; 108 (08) 653-659
  • 8 Cabrini A. LaRiviere, MD, MPH, John H.T. Waldhausen, MD. Congenital Cervical Cysts, Sinuses, and Fistulae in Pediatric Surgery. Surg Clin North Am 2012; 92: 583-597 . Doi: 10.1016/j.suc.2012.03.015
  • 9 Ballivet de Régloix S, Maurin O, Crambert A, Genestier L, Bonfort G, Pons Y. Kystes et fistules congenitaux du cou chez l'adulte. Presse Med 2018; pii: S0755-4982 (18)30376–2.
  • 10 Erickson LA. Branchial Cleft Cyst in Lateral Neck of an Adult. Mayo Clin Proc 2017; 92 (04) e69-e70
  • 11 Muller S, Aiken A, Magliocca K, Chen AY. Second Branchial Cleft Cyst. Head Neck Pathol 2015; 9 (03) 379-383
  • 12 Brea-Álvarez B, Roldán-Hidalgo A. [Cysts in the posterior triangle of the neck in adults]. Acta Otorrinolaringol Esp 2015; 66 (02) 106-110
  • 13 Gourin CG, Johnson JT. Incidence of unsuspected metastases in lateral cervical cysts. Laryngoscope 2000; 110 (10 Pt 1): 1637-1641
  • 14 Sharma SD, Stimpson P. Assessment and management of presumed branchial cleft cysts: our experience. B-ENT 2016; 12 (04) 291-296
  • 15 Agaton-Bonilla FC, Gay-Escoda C. Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients. Int J Oral Maxillofac Surg 1996; 25 (06) 449-452
  • 16 Schroeder Jr JW, Mohyuddin N, Maddalozzo J. Branchial anomalies in the pediatric population. Otolaryngol Head Neck Surg 2007; 137 (02) 289-295 . Doi: 10.1016/j.otohns.2007.03.009
  • 17 Titchener GW, Allison RS. Lateral cervical cysts: a review of 42 cases. N Z Med J 1989; 102 (877) 536-537
  • 18 Kadhim AL, Sheahan P, Colreavy MP, Timon CV. Pearls and pitfalls in the management of branchial cyst. J Laryngol Otol 2004; 118 (12) 946-950
  • 19 Deane SA, Telander RL. Surgery for thyroglossal duct and branchial cleft anomalies. Am J Surg 1978; 136 (03) 348-353
  • 20 Waldhausen JH. Branchial cleft and arch anomalies in children. Semin Pediatr Surg 2006; 15 (02) 64-69 . Doi: 10.1053/j.sempedsurg.2006.02.002
  • 21 Roback SA, Telander RL. Thyroglossal duct cysts and branchial cleft anomalies. Semin Pediatr Surg 1994; 3 (03) 142-146
  • 22 Prosser JD, Myer III CM. Branchial cleft anomalies and thymic cysts. Otolaryngol Clin North Am 2015; 48 (01) 1-14
  • 23 Zaifullah S, Yunus MR, See GB. Diagnosis and treatment of branchial cleft anomalies in UKMMC: a 10-year retrospective study. Eur Arch Otorhinolaryngol 2013; 270 (04) 1501-1506 . Doi: 10.1007/s00405-012-2200-7
  • 24 Fleming WB. Infection in branchial cysts. Aust N Z J Surg 1988; 58 (06) 481-483
  • 25 Work WP, Proctor CA. The otologist and first branchial cleft anomalies. Ann Otol Rhinol Laryngol 1963; 72: 548-562 . Doi: 10.1177/000348946307200221
  • 26 Roh JL, Sung MW, Hyun Kim K, Il Park C. Treatment of branchial cleft cyst with intracystic injection of OK-432. Acta Otolaryngol 2006; 126 (05) 510-514
  • 27 Kim MG, Lee NH, Ban JH, Lee KC, Jin SM, Lee SH. Sclerotherapy of branchial cleft cysts using OK-432. Otolaryngol Head Neck Surg 2009; 141 (03) 329-334