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Branchial Cleft CystAka: Branchial Cleft Sinus, Branchial Cleft, Branchial Cyst, Branchial Sinus, Congenital Branchial Cleft Cyst

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  1. Pathophysiology
    1. Congenital remnant of branchial cleft
    2. Branchial clefts embyogenesis
      1. Composed of 5 paired arches in lateral foregut wall
      2. Arches are separated by clefts
      3. Clefts usually obliterated with development
  2. Types
    1. First Branchial Cleft
      1. Associations
        1. External auditory canal
        2. Parotid Gland
    2. Second Branchial Cleft
      1. Associations
        1. Superior pole of tonsil
      2. Location
        1. Anterior border of sternocleidomastoid muscle
      3. Course
        1. Between internal and external carotid arteries
        2. Opens into tonsillar fossa
    3. Third Branchial Cleft
      1. Associations
        1. Pyriform Sinus
      2. Location
        1. Anterior border of sternocleidomastoid muscle
      3. Course
        1. Posterior to common carotid artery
        2. Opens in Pyriform sinus
  3. Signs
    1. Lateral Neck Mass in distribution as above
      1. Most common at anterior border of sternocleidomastoid
      2. Sinus communicates fully between skin and airway
    2. May present with infection
  4. Complications
    1. Secondary infection with neck abscess
    2. Branchial cleft cyst wall carcinoma (rare)
  5. Differential Diagnosis
    1. See Neck Masses in Children
    2. See Neck Masses in Adults
    3. Squamous Cell Carcinoma of tonsil or Tongue base
  6. Radiology
    1. CT Neck
    2. Fistulogram
  7. Management
    1. Surgical Excision of cyst and sinus tract
  8. References
    1. Noble (2001) Primary Care, Mosby, p. 1772
    2. Townsend (2001) Sabiston Surgery, Saunders, p. 547
    3. Hong (1999) J Laryngol Otol 113(11):1031
    4. Mandell (2000) Otolaryngol Clin North Am 33(6):1309
    5. Palacios (2001) Ear Nose Throat J 80(5):302

Branchioma (C0006131)

Definition (MSH)A tumor derived from branchial epithelium or branchial rests. (Dorland, 27th ed)
ConceptsNeoplastic Process (T191)
ICD9744.42
MSHD001935
EnglishBranchial Cleft Cyst, Branchial Cleft Cysts, Branchial Cyst, Branchial Cysts, Branchioma, Branchiomas, Cyst of branchial cleft, Cyst of the Branchial Cleft
Spanishbranquioma, quiste branquial, quiste de la hendidura branquial
Parent ConceptsBranchial cleft, cyst or fistula; preauricular sinus (C0158595), Cyst (C0010709), Benign Neoplasm (C0086692), Congenital anomaly of neck (C0266623), Veterinary tumor (C0334680), Mass of body structure (C0577559)
SourcesCOSTAR, ICD9CM, MSH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Sinus of branchial cleft (disorder) (C0266624)

ConceptsCongenital Abnormality (T019) , Disease or Syndrome (T047)
ICD9744.41
EnglishBranchial cleft sinus, Branchial sinus, Sinus of branchial cleft
Spanishseno de fistula branquial, seno hendido branquial
Parent ConceptsCongenital anomaly of neck (C0266623), Ambiguous concept (C1274012)
SourcesMTH, MTHICD9, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Branchial Clefts (C1280559)

ConceptsEmbryonic Structure (T018)
MSHD001934
EnglishBranchial cleft, Branchial Clefts, Branchial Groove, Branchial Grooves, Pharyngeal Cleft, Pharyngeal Clefts, Pharyngeal Groove, Pharyngeal Grooves
Spanishhendidura branquial
Parent ConceptsOther Embryologic Structure (C1518650), Posterior triangle of neck (C0230073), Persistent embryonic structure (C0332996), Branchial apparatus structure (C1282439)
SourcesMSH, MTH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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