A cross-sectional evaluation of outcomes of pediatric branchial cleft cyst excision
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Published on: October 20, 2023
Jillian Mattioni1, Sarah Azari2, Travis Hoover3
1Otolaryngology Head and Neck Surgery Resident, Department of Otolaryngology- Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA, 19131, USA.
Insights
Pediatric branchial cleft cyst excision is generally safe across specialties. However, a history of developmental delay is associated with an increased risk of 30-day postoperative complications.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Surgical Outcomes Research
Background:
- Branchial cleft cysts are common congenital anomalies in children.
- Surgical excision is the primary treatment for branchial cleft cysts.
- Understanding complication rates is crucial for patient counseling and surgical planning.
Purpose of the Study:
- To evaluate complications after pediatric branchial cleft cyst excision.
- To identify factors associated with increased complication risk, including surgical specialty, patient demographics, and comorbidities.
Main Methods:
- Retrospective review of the National Surgical Quality Improvement Program (NSQIP) database.
- Inclusion of pediatric patients undergoing branchial cleft cyst excision (CPT codes 42810, 42815) between 2015 and 2017.
- Statistical analysis to determine associations between complications and various patient and surgical factors.
Main Results:
- Of 895 pediatric cases, 5.0% experienced 30-day complications, predominantly superficial surgical site infections.
- No significant differences in complications were found based on surgical specialty, patient demographics, or excision depth.
- A history of developmental delay was significantly associated with a higher incidence of complications (11.1% vs. 4.2%).
Conclusions:
- Pediatric branchial cleft cyst excision is a safe procedure with low overall complication rates.
- A history of developmental delay is a significant risk factor for postoperative complications following this procedure.
- Further research may explore targeted interventions for high-risk pediatric patients.
Objective:
To examine complications following pediatric branchial cleft cyst excision by surgical specialty, demographics, and comorbid conditions.
Methods:
A retrospective review of the National Surgical Quality Improvement Program database was performed. Pediatric cases from January 1, 2015 through May 1, 2017 with a current procedural terminology code of 42810 (excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues) or 42815 (excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into the pharynx) were included. Statistical analysis was performed to assess associations between complications and surgical specialty, demographics, and comorbidities.
Results:
Of the 895 cases that met inclusion criteria, the median age was two years and there was an approximately equal number of males (46.8%) and females (53.2%). Forty-five patients (5.0%) experienced at least one 30-day complication, the most predominant of which was superficial surgical site infection. There was no statistically significant difference between complications and surgical specialty, complications and patient demographics, or complications and depth of excision. There was a statistically significant difference (p = 0.05) in the percentage of patients with a past medical history of developmental delay between those with at least one complication (11.1%) compared to those without any complications (4.2%).
Conclusion And Relevance:
Branchial cleft excision is a generally safe procedure across surgical specialties and patient demographics. There is an association between a history of developmental delay and 30-day postoperative complications.
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