Second branchial cyst in the parapharyngealspace: a case report

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Pathology

Background:

• Parapharyngeal branchial cysts are uncommon congenital anomalies.
• These cysts often present with subtle or absent symptoms, leading to delayed diagnosis.
• Large cysts can cause significant mass effect, displacing vital structures.

Purpose of the Study:

• To present a case of a large retro- and parapharyngeal branchial cyst.
• To discuss the clinical findings and management of this rare condition.
• To review the literature on parapharyngeal cysts and their surgical treatment.

Main Methods:

• A case report of a 54-year-old man with a large parapharyngeal branchial cyst.
• Computed tomography (CT) imaging to delineate the cyst and its relationship to adjacent structures.
• Literature review of parapharyngeal cysts, focusing on diagnosis and treatment modalities.
• Transoral cyst resection was performed.

Main Results:

• A large, well-marginated cystic mass was identified in the left retro- and parapharyngeal spaces on CT.
• The cyst displaced the left internal and common carotid arteries.
• The cyst contained sterile, yellowish pus without evidence of malignancy.
• Transoral resection was completed without surgical complications.
• No recurrence was noted at the 2-year follow-up.

Conclusions:

• Parapharyngeal branchial cysts are rare and frequently present with few symptoms.
• The transoral surgical approach offers excellent exposure for complete resection.
• This approach minimizes post-operative complications and avoids cervical scarring.