Resecting Branchial Fistulae, Sinuses and Cysts

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2025-03-11

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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery

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University of Cape Town

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Abstract
Branchial anomalies may be diagnosed at any age but present most commonly in infancy and childhood as a cutaneous sinus, a cyst or an abscess. The differential diagnosis of a cystic lateral neck mass includes thymic, parathyroid and thyroid cysts, cystic metastases (papillary thyroid carcino-ma, oropharyngeal squamous cell carcinoma, skin cancer), tuberculous cold abscess, lymphatic malformation, plunging ranula, and laryngocoele. The existence of branchiogenic carcinoma is controversial. Cystic metastases to cervical lymph nodes originating from oropharyngeal squamous cell carcinoma occur far more commonly and should be suspected particularly in adult patients presenting with cystic masses in Levels 2 or 3 of the neck.
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