Health Library

Branchial cleft cyst

Cleft sinus

A branchial cleft cyst is a birth defect. It is caused when fluid fills a space, or sinus, left in the neck when a baby develops in the womb. After the baby is born, it appears as a lump in the neck or just below the jawbone.

I Would Like to Learn About:

Causes

Branchial cleft cysts form during development of the embryo. They occur when tissues in the neck area (branchial cleft) fail to develop normally.

The birth defect may appear as open spaces called cleft sinuses, which may develop on one or both sides of the neck. A branchial cleft cyst may form due to fluid in a sinus. The cyst or sinus can become infected.

Symptoms

The cysts are most often seen in children. In some cases, they are not seen until adulthood.

Symptoms may include any of the following:

• Small pits, lumps, or skin tags at either side of the neck or just below the jawbone
• Fluid drainage from a pit on the neck
• Noisy breathing (if the cyst is large enough to block part of the airway)

Exams and Tests

The health care provider may be able to diagnose this condition during a physical examination. The following tests may be done:

• CT scan
• MRI scan
• Ultrasound

Treatment

Antibiotics will be given if the cyst or sinuses are infected.

Surgery is generally needed to remove a branchial cleft cyst in order to prevent complications such as infections. If there is an infection when the cyst is found, surgery will likely be done after the infection has been treated with antibiotics. If there have been several infections before the cyst is found, it may be harder to remove.

Outlook (Prognosis)

Surgery is usually successful, with good results.

Possible Complications

The cyst or sinuses may become infected if not removed. Repeated infections may make surgical removal more difficult.

When to Contact a Medical Professional

Contact your provider for an appointment if you notice a small pit, cleft, or lump in your child's neck or upper shoulder, especially if fluid drains from this area.

Related Information

References

Loveless TP, Altay MA, Wang Z, Baur DA. Management of branchial cleft cysts, sinuses, and fistulae. In: Kademani D, Tiwana PS, eds. Atlas of Oral and Maxillofacial Surgery. St Louis, MO: Elsevier Saunders; 2016:chap 92.

Thatcher AL. Congenital and inflammatory neck masses in children. In: Lesperance MM, eds. Cummings Pediatric Otolaryngology. Philadelphia, PA: Elsevier; 2022:chap 23.

Review Date: 11/9/2021  

Reviewed By: Kimberly G. Lee, MD, MSc, IBCLC, Clinical Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: verify here.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2022 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.