A branchial cleft is a birth defect, meaning it develops in the womb as the baby grows. It occurs when the area does not develop as it should during the early stages of the baby’s growth.
The obvious signs of a branchial cleft cyst include a small or large lump on one side of your neck.
Branchial cleft cysts appear as soft, round swellings in the neck that do not hurt. Although they are present from birth, they begin to cause swelling around the age of 20. The reason for this is that the material collecting inside them builds up over a long period until there is enough to form a mass.
Cyst and fistula
There are two types of branchial cleft anomaly. The first is a closed cyst, which looks like a large lump bulging from the neck.
The second is a fistula, which shows as an opening on the neck and drains onto the surface of the skin.
First branchial cleft cysts usually extend between the external ear canal and the auricle and the angle of the mandible (lower jaw). Third branchial cleft fistulas present as a swelling in the midline of the neck or on the side of the neck.
Infection
A branchial cleft cyst can cause recurrent infections in the area. This means that your branchial cleft cyst can become infected when you have another infection, such as a cold, a cough or a sore throat.
If a branchial cleft cyst becomes infected, there will be swelling, redness, warmth to the touch and pain around the affected area. There may also be a discharge of pus, either when pressure is applied or spontaneously.
Treatment
Surgery is performed because they frequently swell up due to infection and because of the cosmetic deformity they create in the neck. It is rare for these cysts to turn into a malignant tumour. If there is an infection, antibiotic treatment is given first, and the operation is performed afterwards. The tract of the cyst is followed during the operation and removed so that it does not recur.