Branchial Cysts

These type of lumps are present from birth (congenital), however may only present later in adult life. They are the most common congenital cause of a neck lump. Branchial cleft cysts do not often cause symptoms, but may become tender, enlarged, or inflamed with possible abscess formation during episodes of upper respiratory tract infections.

Patients can present with purulent drainage to skin or throat from spontaneous rupture of branchial cleft cyst abscess. The most concerning symptoms include problems with swallowing and breathing.

One of the difficulties with branchial cysts is that they can be difficult to differentiate from a cancerous neck lump, as they can share similar characteristics. It’s important for your specialist to ensure that the cyst is not a malignancy.

Branchial Cyst Diagnosis & Treatment

Branchial cyst diagnostic investigations are usually considered to include a scan and a needle biopsy. If diagnosis is still unclear, then occasionally further detailed tests may be necessary.

Due to the congenital nature of the cyst, it is important your surgeon ensures that the cyst has no deeper connection with the underlying structures within your neck. These may include the structures within your ear such as the nerve supplying the face or the hearing mechanisms. It can also sometimes communicate with the structures deep within your throat.

Once the diagnosis has been confirmed, then there is an option to manage this without surgery and simply observe it. If the lump is causing problems, due to repeated infections, or there are concerns about the appearance cosmetically, then they can be removed surgically.

There is typically no urgency, after the diagnosis is confirmed; clinicians can defer surgery, whilst allowing any acute infection to settle. When a cyst becomes acutely infected, presenting with a painful neck lump with a temperature, then antibiotics and possible (drainage with a needle) aspiration are generally preferable.

Recurrence rates are generally low (<5%), however if there has been previous surgery or infection, they can be as high as 20%. There is small risk to various nerves travelling within the neck, which may include the nerve to the face, tongue and shoulder. It is important your specialist talks to you about this.

In any case, where you need to get expert care from a qualified ENT specialist consultant in Oxford, you can book your consultation today. Firstly, please get in touch with our team by filling out the form here. Priy holds clinics at both Nuffield Health Oxford and GenesisCare.