BRANCHIAL CLEFT CYST ▲ GENERAL INFORMATION DIAGNOSIS Branchial cleft cyst is a condition that has its beginning • Usually the diagnosis can be made by taking a detailed history and doing a careful physical when the neck of the tiny embryo begins to take shape in the mother’s womb. During this time of development, examination. If there are questions about the diagnosis, ultrasound can help clear up any doubts. several deep grooves (branchial clefts) in the neck don’t disappear as they should. As a result, a thin tube of • Ultrasound: Harmless sound waves are aimed at the area of your neck. The sound waves bouncing back tissue not much thicker than spaghetti remains under the skin of the neck. This tube usually runs from the (the echoes) from this area are seen as a picture on a screen. Ultrasound is a convenient, painless, and middle or lower part of the neck upward and inward toward the throat on the side of the neck. Branchial harmless way to examine organs and tissues inside the neck. It is especially useful to determine whether cleft cyst is most commonly seen in children and young adults. the ‘‘mass’’ is solid or filled with fluid. ● TREATMENT COMMON SIGNS AND SYMPTOMS The appropriate treatment for a branchial cleft cyst or • Often, this tube does not cause a problem. At other sinus is an operation to remove it. After consideration times, it drains clear fluid to the outside through an of all factors, the recommendation is that you have an opening in the skin, usually at the lower part of the operation to remove the branchial cleft cyst. side of the neck. • Sometimes, the tube does not have an outside PREOPERATIVE PREPARATION opening, and the fluid accumulates in the tube to create the swelling (a cyst) (Fig. 1). • There will be an examination of your blood and urine • The cyst can be the size of a small olive or as large and possibly of your heart (EKG) and lungs (chest x- as a chicken egg. ray). • Most of the time, the cyst is not painful. However, if • Do not eat or drink anything for 8 hours before the the fluid inside it becomes infected, it can be very operation. painful. • Shower or bathe as usual on the morning of the operation. • You may be given medicine that will make you feel drowsy before you are brought to the operating room. ■ OPERATION • You will be asleep for the operation. • Careful consideration will be given to make a cosmetic incision in a natural crease in the neck. • There will be a cosmetic closure. • The operation usually takes about 1, sometimes 2, hours, depending on how much dissection is necessary. POSTOPERATIVE CARE • You will be taken to a recovery room and observed. When your blood pressure, pulse, and breathing are stable and you are completely alert, you may be able to go home that same day with a responsible adult. Otherwise, you will be taken to a regular hospital room. • There will be a small bandage over the incision. • Pain will be controlled with medicine. • Your diet will be as you tolerate it. • As with any operation, complications are always possible. Although they are uncommon with this type of operation, they can include bleeding, infection, temporary hoarseness, and possibly others. Figure 1. Most often the branchial cleft cyst is found in the lo- • Arrangements will be made for your medicine, cation shown. However, it can be anywhere along a line from the bottom of the ear to the breast bone. follow-up office visit, and stitch removal. q Copyright 1999 by WB Saunders Company. All rights reserved. BRANCHIAL CLEFT CYST 83
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BRANCHIAL CLEFT CYST
▲ GENERAL INFORMATION DIAGNOSISBranchial cleft cyst is a condition that has its beginning • Usually the diagnosis can be made by taking a
detailed history and doing a careful physicalwhen the neck of the tiny embryo begins to take shapein the mother’s womb. During this time of development, examination. If there are questions about the
diagnosis, ultrasound can help clear up any doubts.several deep grooves (branchial clefts) in the neck don’tdisappear as they should. As a result, a thin tube of • Ultrasound: Harmless sound waves are aimed at the
area of your neck. The sound waves bouncing backtissue not much thicker than spaghetti remains underthe skin of the neck. This tube usually runs from the (the echoes) from this area are seen as a picture on a
screen. Ultrasound is a convenient, painless, andmiddle or lower part of the neck upward and inwardtoward the throat on the side of the neck. Branchial harmless way to examine organs and tissues inside
the neck. It is especially useful to determine whethercleft cyst is most commonly seen in children andyoung adults. the ‘‘mass’’ is solid or filled with fluid.
● TREATMENTCOMMON SIGNS AND SYMPTOMSThe appropriate treatment for a branchial cleft cyst or
• Often, this tube does not cause a problem. At other sinus is an operation to remove it. After considerationtimes, it drains clear fluid to the outside through an of all factors, the recommendation is that you have anopening in the skin, usually at the lower part of the operation to remove the branchial cleft cyst.side of the neck.• Sometimes, the tube does not have an outside
PREOPERATIVE PREPARATIONopening, and the fluid accumulates in the tube tocreate the swelling (a cyst) (Fig. 1). • There will be an examination of your blood and urine
• The cyst can be the size of a small olive or as large and possibly of your heart (EKG) and lungs (chest x-as a chicken egg. ray).
• Most of the time, the cyst is not painful. However, if • Do not eat or drink anything for 8 hours before thethe fluid inside it becomes infected, it can be very operation.painful. • Shower or bathe as usual on the morning of the
operation.• You may be given medicine that will make you feel
drowsy before you are brought to the operatingroom.
■ OPERATION• You will be asleep for the operation.• Careful consideration will be given to make a
cosmetic incision in a natural crease in the neck.• There will be a cosmetic closure.• The operation usually takes about 1, sometimes 2,
hours, depending on how much dissection isnecessary.
POSTOPERATIVE CARE• You will be taken to a recovery room and observed.
When your blood pressure, pulse, and breathing arestable and you are completely alert, you may be ableto go home that same day with a responsible adult.Otherwise, you will be taken to a regular hospitalroom.
• There will be a small bandage over the incision.• Pain will be controlled with medicine.• Your diet will be as you tolerate it.• As with any operation, complications are always
possible. Although they are uncommon with this typeof operation, they can include bleeding, infection,temporary hoarseness, and possibly others.Figure 1. Most often the branchial cleft cyst is found in the lo-
• Arrangements will be made for your medicine,cation shown. However, it can be anywhere along a line fromthe bottom of the ear to the breast bone. follow-up office visit, and stitch removal.
q Copyright 1999 by WB Saunders Company. All rights reserved. BRANCHIAL CLEFT CYST 83
✚ HOME CARE • You may drive a car if you wish but not if you aretaking any medicines that reduce your alertness.• Resume your usual activities.
• You may return to work when you feel up to it.• You may walk about as you wish, even climb stairs.• You may eat as you did before the operation.
✆ CALL OUR OFFICE IF• Take medicine as prescribed for your pain.• You develop any unusual signs or symptoms.• You may shower if you wish and with any dressings• The incision becomes red or swollen, or there ison or off.
drainage from it.• There may be narrow strips of tape across the• You develop a temperature higher than 1007F.incision. It’s all right if they get wet; they will be• You have any questions.removed in the doctor’s office.
• After you dry yourself, replace any dressings withclean, dry ones.
q Copyright 1999 by WB Saunders Company. All rights reserved.84 BRANCHIAL CLEFT CYST
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