Parapharyngeal second branchial cyst: A case report

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Head and Neck Surgery

Background:

• Branchial cleft cysts are congenital anomalies, typically presenting in the neck.
• Cysts extending to the pharyngeal wall, particularly the parapharyngeal space, are exceptionally rare.
• Diagnosis and management can be challenging due to the complex anatomy involved.

Purpose of the Study:

• To report a rare case of a pediatric patient with a branchial cleft cyst extending to the parapharyngeal space.
• To describe the diagnostic approach and surgical management of this rare presentation.
• To highlight the importance of considering pharyngeal extension in branchial cleft cyst evaluation.

Main Methods:

• A case study of an eight-year-old female child with a cystic swelling in the left parotid region.
• Diagnostic imaging included computed tomography (CT) scan to delineate cyst extent.
• Surgical management involved a combined transcervical excision of the external component and oral marsupialization of the internal component.

Main Results:

• CT scan confirmed the cyst extended from the parotid region into the left parapharyngeal space.
• A bluish cyst was identified anterior to the anterior tonsillar pillar.
• The combined surgical approach successfully managed the cyst's external and internal components.

Conclusions:

• Branchial cleft cysts with pharyngeal wall extension, though rare, require careful diagnostic evaluation and tailored surgical planning.
• A combined surgical approach may be effective for managing complex cysts involving both external and internal pharyngeal spaces.
• This case underscores the anatomical variations and surgical considerations for branchial cleft cysts.