Biopsy and careful evaluation are crucial, and CT scanning can delineate the extent of the mass and the location of major vessels. 4 E First branchial cleft cysts are periauricular and are associated with the external auditory canal. Second and third branchial cleft cysts are located anterior to the sternocleidomastoid muscle and drain into the tonsillar bed and pharynx, respectively. In general, a branchial cleft cyst is usually a single mass that may present in children or adults. Pus aspirated from the cyst contains cholesterol crystals on microscopic examination.
Treatment involves antibiotics and removal of the mass.
Branchial cleft cystsshould be differentiated from 1. Thyroglossal duct cysts. Thyroglossal duct cysts are embryologic remnants of the thyroid gland's tract as it descends down into the neck. These cysts are usually located at the midline and over the hyoid bone or thyroid cartilage. Excision of the cyst along with a portion of the hyoid bone and 2.