Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-25T22:36:38.466Z Has data issue: false hasContentIssue false
  • English
  • Français

Branchial cleft anomalies: accuracy of pre-operative diagnosis, clinical presentation and management

Published online by Cambridge University Press:  12 April 2012

L-A Guldfred ,
B B Philipsen  and
C Siim
L-A Guldfred*
Affiliation:
Department of Otolaryngology, Roskilde County Hospital, Denmark
B B Philipsen
Affiliation:
Department of Otolaryngology, Roskilde County Hospital, Denmark
C Siim
Affiliation:
Department of Otolaryngology, Roskilde County Hospital, Denmark
*
Address for correspondence: Dr Liviu-Adelin Guldfred, Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet, F 2071, Blegdamsvej 9, Copenhagen, Denmark E-mail: kliviu@guldfred.dk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To examine the accuracy of the pre-operative diagnosis of branchial cleft anomalies, and also to describe their occurrence, clinical presentation and management.

Methods:

Retrospective review of the records of patients diagnosed with a branchial cleft anomaly between 1997 and 2006.

Results:

One hundred and twenty-six patients were included. Pre-operative diagnosis had a positive predictive value of 0.856 (95 per cent confidence interval, 0.771–0.918) and a sensitivity of 0.944 (95 per cent confidence interval, 0.869–0.979). These patients' demographic data, investigations, findings and management are presented, along with a possible strategy for dealing with solitary cystic masses in the neck.

Conclusion:

As pre-operative diagnosis has a positive predictive value of 86 per cent, cystic lesions in the neck should be presumed to be carcinomatous until proven otherwise. Branchial fistulae and sinuses seem to be a disease of childhood, while branchial cysts occur mainly in adults. Branchial cleft anomalies are equally frequent in men and women, and equally distributed on the left and right side of the neck.

Keywords

Branchial Cleft CystFistulaDiagnosisPredictive Value Of TestsSensitivitySpecificityCarcinoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 6 , June 2012 , pp. 598 - 604
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Glosser, JW, Pires, CA, Feinberg, SE. Branchial cleft or cervical lymphoepithelial cysts: etiology and management. J Am Dent Assoc 2003;134:81–6CrossRefGoogle ScholarPubMed
2Agaton-Bonilla, FC, Gay-Escoda, C. Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients. Int J Oral Maxillofac Surg 1996;25:449–52CrossRefGoogle ScholarPubMed
3Gourin, CG, Johnson, JT. Incidence of unsuspected metastases in lateral cervical cysts. Laryngoscope 2000;110:1637–41CrossRefGoogle ScholarPubMed
4Kenealy, JF, Torsiglieri, AJ Jr, Tom, LW. Branchial cleft anomalies: a five-year retrospective review. Trans PA Acad Ophthalmol Otolaryngol 1990;42:1022–5Google ScholarPubMed
5Schroeder, JW Jr, Mohyuddin, N, Maddalozzo, J. Branchial anomalies in the pediatric population. Otolaryngol Head Neck Surg 2007;137:289–95CrossRefGoogle ScholarPubMed
6Daoud, FS. Branchial cyst: an often forgotten diagnosis. Asian J Surg 2005;28:174–8CrossRefGoogle ScholarPubMed
7Newcombe, RG. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 1998;17:857–723.0.CO;2-E>CrossRefGoogle ScholarPubMed
8Titchener, GW, Allison, RS. Lateral cervical cysts: a review of 42 cases. N Z Med J 1989;102:536–7Google ScholarPubMed
9Hardee, PS, Hutchison, IL. Solitary nodal metastases presenting as branchial cysts: a diagnostic pitfall. Ann R Coll Surg Engl 1999;81:296–8Google ScholarPubMed
10Sheahan, P, O'Leary, G, Lee, G, Fitzgibbon, J. Cystic cervical metastases: incidence and diagnosis using fine needle aspiration biopsy. Otolaryngol Head Neck Surg 2002;127:294–8CrossRefGoogle ScholarPubMed
11Flanagan, PM, Roland, NJ, Jones, AS. Cervical node metastases presenting with features of branchial cysts. J Laryngol Otol 1994;108:1068–71CrossRefGoogle ScholarPubMed
12Granstrom, G, Edstrom, S. The relationship between cervical cysts and tonsillar carcinoma in adults. J Oral Maxillofac Surg 1989;47:16–20CrossRefGoogle ScholarPubMed
13Thompson, LD, Heffner, DK. The clinical importance of cystic squamous cell carcinomas in the neck: a study of 136 cases. Cancer 1998;82:944–563.0.CO;2-#>CrossRefGoogle Scholar
14Kadhim, AL, Sheahan, P, Colreavy, MP, Timon, CV. Pearls and pitfalls in the management of branchial cyst. J Laryngol Otol 2004;118:946–50CrossRefGoogle ScholarPubMed
15Deane, SA, Telander, RL. Surgery for thyroglossal duct and branchial cleft anomalies. Am J Surg 1978;136:348–53CrossRefGoogle ScholarPubMed
16Maran, AG, Buchanan, DR. Branchial cysts, sinuses and fistulae. Clin Otolaryngol Allied Sci 1978;3:77–92CrossRefGoogle ScholarPubMed
17Doshi, J, Anari, S. Branchial cyst side predilection: fact or fiction? Ann Otol Rhinol Laryngol 2007;116:112–14CrossRefGoogle ScholarPubMed
18Fleming, WB. Infection in branchial cysts. Aust N Z J Surg 1988;58:481–3CrossRefGoogle ScholarPubMed
19Frierson, HF Jr.Cysts of the head and neck sampled by fine-needle aspiration: sources of diagnostic difficulty. Am J Clin Pathol 1996;106:559–60CrossRefGoogle ScholarPubMed