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Surgery

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Thyroid & Adrenal

Question
29 out of 99
 

The most common site of the branchial cyst is:



A At upper third of the sternomastoid muscle

B At lower third of sternomastoid muscle

C Close to pharynx

D In posterior triangle of neck

Ans. B At lower third of sternomastoid muscle (REF. SCHWARTZ SURGERY 8TH EDN PG 515)

a. Branchial cleft cysts are congenital epithelial cysts, which arise on the lateral part of the neck from a failure of obliteration of the second branchial cleft in embryonic development.

b. A branchial cyst commonly presents as a solitary, painless mass in the neck of a child or a young adult.

c. A history of intermittent swelling and tenderness of the lesion during upper respiratory tract infection may exist. Discharge may be reported if the lesion is associated with a sinus tract.

d. Primary branchial cleft cyst lesion: Branchial cysts are smooth, nontender, fluctuant masses, which occur along the lower one third of the anteromedial border of the sternocleidomastoid muscle between the muscle and the overlying skin.

e. Secondary branchial cleft cyst lesion: The lesion may be tender if secondarily inflamed or infected. When associated with a sinus tract, mucoid or purulent discharge onto the skin or into the pharynx may be present.

f. Surgical excision is definitive treatment for branchial cleft cysts.

g. Branchial cleft cyst surgery is best delayed until the patient is at least age 3 months.

h. Definitive branchial cleft cyst surgery should not be attempted during an episode of acute infection or if an abscess is present. Surgical incision and drainage of abscesses is indicated if present, usually along with concurrent antimicrobial therapy.

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