Congenital malformations: cysts and lateral fistulas of the neck (branchial cyst)

By Cristiano Antonino On May 21, 2023

Cysts and lateral fistulas of the neck (branchial cyst) are congenital malformations and depend on anomalies in the development of the organs of the fetus from which the head and neck derive

The lateral neck cyst (also called a branchial cyst) is a congenital malformation

It derives from an anomaly in the development of the organs of the fetus from which the head and neck derive (the gill pouches).

From a practical point of view, without going into embryological and anatomical details, which are difficult to understand even for experts, depending on the part of the neck where the cyst or fistula is located, it can be deduced from which part of the embryo the cyst itself and what facilitates a correct and complete removal operation.

The lateral cysts of the neck show signs of them due to the presence of a palpable swelling, usually with well-defined margins, rounded, painless.

In case of fistula, the presence of a mucous secretion is associated

Sometimes the onset of symptoms coincides with an infection of the nose or throat.

The only treatment is surgery, with possible antibiotic medical therapy to be associated in case of local inflammation.

The surgery must be performed in the non-infectious phase to avoid the risk of nerve damage and limit the risk of recurrence.

The surgery is performed under ordinary hospitalization with surgery on the same day unless other diseases are present.

In the case of a cyst, the operation involves the removal of the same with an incision at the level of the palpable swelling

In the case of a fistula, the incision involves a lozenge with removal of the surrounding skin.

The fistula is followed upwards until it reaches its origin and to ensure that the removal is complete, it may sometimes be necessary to make a second incision.

The closure of the surgical incision is usually made with absorbable material.

Postoperative pain is usually minimal and rarely requires pain-relieving drug treatment.

Bleeding is rare and usually, except in exceptional cases, heals spontaneously.

When the operation seems to have been more difficult, it may be useful at the end of the procedure to place an aspiration drainage, which will be kept in place for 1-3 days.

Infections, abscess formation, and impaired wound healing are also rare and rarely require a new operation.