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Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is branchial cyst? What is its origin?
• What are symptoms of a branchial cyst?
• What are structures in the neck that can be similar to a branchial cyst?
• How is a branchial cyst treated?
• Branchial Cyst Index

Branchial cysts usually cause no immediate problem. They can cause a pressure sensation in the area affected. Sometimes it develops a sinus or drainage pathway to the surface of the skin from which mucus can be expressed. They are typically not tender. Rarely, however, they can become infected.

There can be other structures in the neck area of a similar character. These include

1. Cystic hygroma: This structure is a malformation of the lymphatic system in the neck region. The lymphatic system is composed of a series of vessels that drain a milky white liquid (lymph) that contains fluid and white blood cells for fighting infection. In comparison with a branchial cleft cyst, a cystic hygroma is also smooth and soft but is located behind the sternocleidomastoid muscle.



2. Thyroglossal duct cyst: This structure commonly drains from inside the floor of the mouth to an opening similar to that of a branchial cleft cyst, but it's located in the center of the neck in the area of the larynx (voice box).



3. Swelling of the thyroid gland: This soft structure has two lobes that are located on either side of the windpipe (trachea) at the level of the vocal cords. There is a thin connection of thyroid tissue that bridges the two lobes and crosses over the trachea.



4. Miscellaneous: collections of fat (lipomas), collections of blood vessels (hemangiomas), sebaceous cysts, etc.

Total surgical excision is the treatment of choice. Recurrence is not expected.