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A branchial cleft cyst is a birth defect that appears as a lump, pit, or skin tag on the neck or collarbone area. It can become infected and may require surgery or sclerotherapy for treatment.
A branchial cleft cyst, also known as a cleft sinus, is a birth defect that appears on the sides of the neck or below the collarbone. It occurs when the embryonic tissues in the collarbone and neck areas do not develop normally. A lesion similar to the cracks found in the gills of fish usually forms; this is where the cyst forms. It can collect drainage fluid from the sinuses making it prone to infections. Although the cyst forms during the embryonic stage, it may not be noticed until early adulthood.
In many cases, a branchial cleft cyst will not present any symptoms. It can manifest as a small lump, pit, or skin tag on either side of the neck or under the collarbone area. If a pit forms, fluid from the sinuses can drain out of it. Sometimes the cyst can become tender to the touch, while other times it can become inflamed, enlarged, or even abscessed if the affected person has an upper respiratory tract infection. If the lump is large, symptoms may include difficulty swallowing, difficulty breathing, or hoarseness.
There are two different types of branchial cleft cyst lesions: primary and secondary. The primary lesion is smooth and painless to the touch, while the secondary is tender, especially if infected. If the cyst becomes infected, it must be treated immediately with antibiotics.
In addition to treating the associated infection with a course of antibiotics, one way to treat someone with this birth defect is surgery. Usually, a surgeon will make a series of horizontal incisions to remove the cyst. Surgery is not recommended for patients younger than three months of age, although there are always medical exceptions. If the person has a severe infection or abscess, surgery should not be done until the infection or abscess has cleared up.
In some cases, surgery is insufficient and other forms of treatment are needed. Some people have opted for sclerotherapy, a more commonly used treatment for varicose veins. When used on a branchial cleft cyst, the fluid in the cyst is drained. Then, the cyst is injected with a drug called a sclerosing agent, specifically OK-432. According to research, the cyst will disappear completely in almost half of the cases.
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