Cystic remnant of cervical sinus of His: Derivative of 2nd, 3rd, and 4th branchial clefts
Sinus: Usually communicates externally along anterior margin of sternocleidomastoid muscle (SCM)
Rarely communicates internally to tonsillar fossa
Fistula: Communicates externally and internally
Secondary to persistence of both branchial cleft and pharyngeal pouch remnant
Combinations
Cyst + sinus &/or fistula
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Gao S et al: Endoscopically assisted transoral resection of a Bailey type IV second branchial cleft cyst: A case report. Medicine (Baltimore). 100(3):e24375, 2021
Ginat DT: Imaging findings in syndromes with temporal bone abnormalities. Neuroimaging Clin N Am. 29(1):117-28, 2019
Hsu A et al: The unwound cochlea: a specific imaging marker of branchio-oto-renal syndrome. AJNR Am J Neuroradiol. 39(12):2345-9, 2018
Thottam PJ et al: Complete second branchial cleft anomaly presenting as a fistula and a tonsillar cyst: an interesting congenital anomaly. Ear Nose Throat J. 93(10-11):466-8, 2014
Chen LS et al: Endoscope-assisted versus conventional second branchial cleft cyst resection. Surg Endosc. 26(5):1397-402, 2012
Goff CJ et al: Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 20(6):533-9, 2012
Bajaj Y et al: Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 75(8):1020-3, 2011
Buchanan MA et al: Cystic schwannoma of the cervical plexus masquerading as a type II second branchial cleft cyst. Eur Arch Otorhinolaryngol. 266(3):459-62, 2009
Hudgins PA et al: Second branchial cleft cyst: not!! AJNR Am J Neuroradiol. 30(9):1628-9, 2009
Gupta AK et al: Bilateral first and second branchial cleft fistulas: a case report. Ear Nose Throat J. 87(5):291-3, 2008
Koch BL: Cystic malformations of the neck in children. Pediatr Radiol. 35(5):463-77, 2005
Lanham PD et al: Second brachial cleft cyst mimic: case report. AJNR Am J Neuroradiol. 26(7):1862-4, 2005
Kemperman MH et al: Evidence of progression and fluctuation of hearing impairment in branchio-oto-renal syndrome. Int J Audiol. 43(9):523-32, 2004
Ceruti S et al: Temporal bone anomalies in the branchio-oto-renal syndrome: detailed computed tomographic and magnetic resonance imaging findings. Otol Neurotol. 23(2):200-7, 2002
Choo MJ et al: A case of second branchial cleft cyst with oropharyngeal presentation. J Korean Med Sci. 17(4):564-5, 2002
Kemperman MH et al: Inner ear anomalies are frequent but nonobligatory features of the branchio-oto-renal syndrome. Arch Otolaryngol Head Neck Surg. 128(9):1033-8, 2002
Shin JH et al: Parapharyngeal second branchial cyst manifesting as cranial nerve palsies: MR findings. AJNR Am J Neuroradiol. 22(3):510-2, 2001
Lev S et al: Imaging of cystic lesions. Radiol Clin North Am. 38(5):1013-27, 2000
Ahuja A et al: Solitary cystic nodal metastasis from occult papillary carcinoma of the thyroid mimicking a branchial cyst: a potential pitfall. Clin Radiol. 53(1):61-3, 1998
Choi SS et al: Branchial anomalies: a review of 52 cases. Laryngoscope. 105(9 Pt 1):909-13, 1995
Benson MT et al: Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 12(5):943-60, 1992
Doi O et al: Branchial remnants: a review of 58 cases. J Pediatr Surg. 23(9):789-92, 1988
Harnsberger HR et al: Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 152(3):739-48, 1984
Bailey H: The clinical aspect of branchial cysts. In: Branchial Cysts and Other Essays on Surgical Subjects in the Facio-cervical Region. London: H.K. Lewis. 1-18, 1929
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
2nd branchial cleft cyst (BCC)
Synonyms
2nd branchial apparatus cyst (BAC)
2nd branchial apparatus anomaly (BAA)
Definitions
2nd BCC: Most common BAC
Cystic remnant of cervical sinus of His: Derivative of 2nd, 3rd, and 4th branchial clefts
Sinus: Usually communicates externally along anterior margin of sternocleidomastoid muscle (SCM)
Rarely communicates internally to tonsillar fossa
Fistula: Communicates externally and internally
Secondary to persistence of both branchial cleft and pharyngeal pouch remnant
Combinations
Cyst + sinus &/or fistula
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Gao S et al: Endoscopically assisted transoral resection of a Bailey type IV second branchial cleft cyst: A case report. Medicine (Baltimore). 100(3):e24375, 2021
Ginat DT: Imaging findings in syndromes with temporal bone abnormalities. Neuroimaging Clin N Am. 29(1):117-28, 2019
Hsu A et al: The unwound cochlea: a specific imaging marker of branchio-oto-renal syndrome. AJNR Am J Neuroradiol. 39(12):2345-9, 2018
Thottam PJ et al: Complete second branchial cleft anomaly presenting as a fistula and a tonsillar cyst: an interesting congenital anomaly. Ear Nose Throat J. 93(10-11):466-8, 2014
Chen LS et al: Endoscope-assisted versus conventional second branchial cleft cyst resection. Surg Endosc. 26(5):1397-402, 2012
Goff CJ et al: Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 20(6):533-9, 2012
Bajaj Y et al: Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 75(8):1020-3, 2011
Buchanan MA et al: Cystic schwannoma of the cervical plexus masquerading as a type II second branchial cleft cyst. Eur Arch Otorhinolaryngol. 266(3):459-62, 2009
Hudgins PA et al: Second branchial cleft cyst: not!! AJNR Am J Neuroradiol. 30(9):1628-9, 2009
Gupta AK et al: Bilateral first and second branchial cleft fistulas: a case report. Ear Nose Throat J. 87(5):291-3, 2008
Koch BL: Cystic malformations of the neck in children. Pediatr Radiol. 35(5):463-77, 2005
Lanham PD et al: Second brachial cleft cyst mimic: case report. AJNR Am J Neuroradiol. 26(7):1862-4, 2005
Kemperman MH et al: Evidence of progression and fluctuation of hearing impairment in branchio-oto-renal syndrome. Int J Audiol. 43(9):523-32, 2004
Ceruti S et al: Temporal bone anomalies in the branchio-oto-renal syndrome: detailed computed tomographic and magnetic resonance imaging findings. Otol Neurotol. 23(2):200-7, 2002
Choo MJ et al: A case of second branchial cleft cyst with oropharyngeal presentation. J Korean Med Sci. 17(4):564-5, 2002
Kemperman MH et al: Inner ear anomalies are frequent but nonobligatory features of the branchio-oto-renal syndrome. Arch Otolaryngol Head Neck Surg. 128(9):1033-8, 2002
Shin JH et al: Parapharyngeal second branchial cyst manifesting as cranial nerve palsies: MR findings. AJNR Am J Neuroradiol. 22(3):510-2, 2001
Lev S et al: Imaging of cystic lesions. Radiol Clin North Am. 38(5):1013-27, 2000
Ahuja A et al: Solitary cystic nodal metastasis from occult papillary carcinoma of the thyroid mimicking a branchial cyst: a potential pitfall. Clin Radiol. 53(1):61-3, 1998
Choi SS et al: Branchial anomalies: a review of 52 cases. Laryngoscope. 105(9 Pt 1):909-13, 1995
Benson MT et al: Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 12(5):943-60, 1992
Doi O et al: Branchial remnants: a review of 58 cases. J Pediatr Surg. 23(9):789-92, 1988
Harnsberger HR et al: Branchial cleft anomalies and their mimics: computed tomographic evaluation. Radiology. 152(3):739-48, 1984
Bailey H: The clinical aspect of branchial cysts. In: Branchial Cysts and Other Essays on Surgical Subjects in the Facio-cervical Region. London: H.K. Lewis. 1-18, 1929
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