Sabtu, 07 Januari 2012

What is a Branchial Cleft Cyst?

Your little one has a mass on the side of his neck. After a variety of doctor visits it is determined that in all likelihood, the child is developing a branchial cleft cyst – or branchial cleft anomaly. While you may not want to force your child to have surgery to remove this harmless cyst, there is a pretty compelling argument for cyst removal.

A branchial cleft fistula and cyst are found in the neck and composed of tissue that was trapped when the neck was first developing; which means that the cyst is a form of birth defect, not the result of something that has happened since the child was born. The soft lump or drainage opening on one side of the neck can appear at any age, but is most likely to form within the first ten years of your child’s development.

When a cyst develops with a fistula, it follows a generally predictable pattern, because the fistula connects to the cyst at a specific area in the throat. It is important to understand the relationship among these elements so the entire cyst can be removed in a way that it will not have a chance to recur.

There are three kinds of branchial cleft cysts – Type I, Type II and Type III. Each forms in slightly different places. The first branchial clef cyst originates along the jaw line and can extend to the ear canal; and it is often associated with the facial nerve. Type II cysts are more common and can stretch from the neck muscles to the tonsils. The final kind of branchial cleft cyst is found solely in the neck and is a very rare form of cyst.

Before your child can be diagnosed with a branchial cleft cyst, a doctor will use a CT scan to identify the exact location of the mass as well as its relation to blood vessels and neck nerves. Once the mass is found, a pediatric ENT will likely suggest removing it before it can become infected and turn into an abscess.

Surgery to remove the branchial cleft cyst is usually done under general anesthesia. An incision is made over the cyst and it is easily removed. Generally pediatric ENTs will try to make the incision over a skin crease to decrease visible scarring. They also employ plastic surgery techniques to close the incision. The surgery usually lasts between one and two hours and is an outpatient procedure. Pediatric ENTs are the most qualified to handle this type of surgery, as they are specially trained in the specific complications that can arise when removing a cyst near the neck and facial muscles.

If the branchial cleft cyst is infected prior to the surgery to remove it or it has formed an abscess, it may be necessary to drain the abscess first. The infected cyst will be treated with antibiotics until it can be safely removed at a later date.

It is important to call your pediatrician or pediatric ENT as soon as you notice a small pit, cleft or lump in your child’s neck or upper shoulders. It is especially urgent if you see fluids draining from that area. While the cyst is benign, it can cause serious problems if it becomes infected. Acting at the first sign of a cyst can save your child from painful infections in the future.

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