Conditions: Branchial Cleft Abnormalities (Branchial Cleft Cysts, Branchial Cleft Fistulas)

how is a branchial cleft cyst diagnosed and differentiated from other neck masses?

Accurate diagnosis of a branchial cleft cyst (or fistula) depends on your physician taking a good history and performing a thorough head and neck examination. The diagnosis of branchial cleft cysts is typically made by history and physical exam due to their relatively consistent location in the neck, typically anterior to the sternocleidomastoid muscle. For masses presenting in adulthood, the presumption should be a malignancy until proven otherwise, since carcinomas of the tonsil, tongue base and thyroid may all present as cystic masses of the neck. A branchial cleft cyst should be one mass, and the presence of multiple neck masses is not consistent with this diagnosis. Examination of the throat, possibly with a fiberoptic endoscopy, may also help identify supportive or not supportive findings. A tumor in the throat, for example, would suggest that the neck mass is spread of the throat tumor to a lymph node in the neck. Imaging, such as with an ultrasound or CT scan may be undertaken. In some cases, a fine needle aspiration biopsy may be performed to analyze the contents of the cyst and rule out other potential causes, such as a cancer. Consulting with an otolaryngologist — head and neck surgeon can further aid in accurately diagnosing and distinguishing a branchial cleft cyst from other neck masses and provide appropriate surgical management.