Branchial Cleft Cysts: A 152-Case Experience From a Tertiary Center

Objective: Branchial cleft cysts (BCCs) are the second most encountered congenital lesions of the neck. Clinical evaluation and radiological assessment are essential in establishing the diagnosis of these anomalies, and surgical management remains the standard therapeutic approach. In this current study, we sought to contribute updated knowledge to the existing literature by evaluating branchial cleft cyst cases within our patient population.Material and Methods: Medical records of individuals who underwent surgical treatment for branchial cleft anomalies at the Department of Otorhinolaryngology – Head and Neck Surgery, Istanbul Faculty of Medicine, were reviewed. Patients with incomplete preoperative information and/or postoperative follow-up data were excluded from the study. A total of 152 patients were enrolled to the study. Age, sex, clinical presentation, lesion site, subtype of branchial anomaly, history of prior surgical procedures, postoperative complications, and recurrence was assessed.Results: In our cohort, 124 patients (81.57%) presented with second branchial cleft anomalies, whereas 19 (12.5%) exhibited first, 8 (5.26%) third, and one patient (0.6%) fourth branchial cleft cysts. The mean age was 28.51 years. The mean age of patients with third branchial cleft anomalies was 18 years, whereas those with first branchial cleft anomalies had a mean age of 23.61 years. Five individuals (3.9%) required revision surgery due to recurrence. In two patients, histopathological evaluation demonstrated squamous cell carcinoma (branchioma) arising within a branchial cleft cyst (1.3%). Postoperative marginal mandibular nerve paresis occurred in two patients (1.3%), while permanent paralysis was not encountered.Conclusion: Surgical management remains the primary therapeutic approach for BCCs. Surgery is an effective approach with low incidence of recurrence and favorable postoperative complication rates.