Should a branchial cyst be removed?
The treatment for branchial cleft cysts and sinus tracts is surgical removal. There is no known medical therapy with the exception that infected branchial cleft cysts and sinus tracts do require initial antibiotic treatment. The infection should be resolved before surgery is performed.
What is branchial fistula?
Branchial cleft fistulae are rare congenital abnormalities that arise from the abnormal persistence of branchial apparatus remnants. A complete fistula is a tract that has an internal opening and an external opening.
What is branchial cleft anomaly?
Branchial cleft cysts (also called branchial cleft remnants or branchial cleft anomalies) are a congenital condition (condition present at birth) in which tissue develops incorrectly on one or both sides of the neck. Branchial cleft cysts sometimes have openings on the inside or outside of the skin called sinus tracts.
Are branchial and pharyngeal arches the same?
The pharyngeal arches, also known as visceral arches, are structures seen in the embryonic development of vertebrates that are recognisable precursors for many structures. In fish, the arches are known as the branchial arches, or gill arches. The vasculature of the pharyngeal arches is known as the aortic arches.
Can you drain a branchial cyst?
Doctors tend to avoid definitive branchial cleft surgery when there’s an active infection or a presence of an abscess. If there are abscesses present, surgical incision and drainage are needed along with antibiotics.
What causes branchial fistula?
What are the causes? Branchial cleft cysts and sinus tracts are congenital anomalies, meaning they result from an unexpected change in the womb before birth. Although most commonly unilateral (occurring on one side of the neck), they can be bilateral (both sides of the neck).
Is branchial cleft cyst rare?
Branchial cleft cyst is a rare disease of the head and neck. Because of its rarity, it is often misdiagnosed. Although present at birth, many cases do not become evident until later in childhood or adolescence, with an initial clinical presentation in adulthood being encountered rarely.
What is First branchial cleft?
First branchial cleft cysts develop as a result of incomplete fusion of the cleft between the first and second branchial arches and give rise to two distinct anomalies, termed type I and type II anomalies. Type I anomalies are purely ectodermal while type II anomalies exhibit ectodermal and mesodermal elements.
How rare is branchial cleft cyst?
The exact incidence of branchial cleft cysts in the US population is unknown. Branchial cleft cysts are the most common congenital cause of a neck mass. An estimated 2-3% of cases are bilateral. A tendency exists for cases to cluster in families.
What are the different branchial pouches?
Embryogenesis. The branchial apparatus consists of four pairs of arches separated externally by four paired grooves and internally by four paired pouches. The external grooves are called branchial clefts, and the internal pouches are known as pharyngeal pouches; they are separated by their branchial plates.
Which branchial arch gives rise to branchial cyst?
Branchial cleft cysts develop early during gestation. During week 4 of embryonic development, four branchial (pharyngeal) clefts form five ridges. These ridges contribute to the formation of portions of the head, neck, and thorax. These mesodermal ridges form the 6 branchial (pharyngeal) arches.
What is the fourth branchial pouch anomalies?
Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence.
How are the pouches and clefts of the branchial apparatus numbered?
Branchial pouches and clefts are likewise numbered craniocaudally (Fig. 12-7 ). The first branchial arch (Meckel’s) cartilage is the position of the future mandible, as well as the eventual malleus and incus.
How many arches are there in the branchial apparatus?
Branchial apparatus include 6 arches (mesoderm) interfaced by 4 clefts (ectoderm) and pouches (endoderm) on each side at the end of fourth week of embryonic life. Mario A. Luna, Madeleine Pfaltz, in Diagnostic Surgical Pathology of the Head and Neck (Second Edition), 2009
What does the second branchial arch cartilage produce?
The second branchial arch cartilage produces the stapes, the styloid process, the stylohyoid ligament, and the superior portion of the body of the hyoid. The other branchial arch cartilages contribute to the inferior portion of the hyoid as well as the thyroid cartilage.