Transoral Endoscopic Excision of Second Branchial Cleft Cyst-A Case Report

Abstract

Branchial cleft cysts are congenital anomalies arising from the first through fourth pharyngeal 
clefts. Defects of the branchial apparatus manifest as cysts, sinuses, fistulas, and ectopic 
glands1
. Anomalies arise most commonly from the second branchial cleft followed by first, 
third and fourth arches2
. The occurrence of a branchial cleft cyst in the parapharyngeal space 
is rare and accounts for 1% of parapharyngeal tumors. Though there are various surgical 
approaches to the parapharyngeal space, the risk of complications leading to loss of quality of 
life remains high due to the presence of anatomically important vascular and neural structures 
in the vicinity.3,4 We hereby report the successful surgical treatment of a branchial cleft cyst in 
a young woman’s parapharyngeal space, with control of infection, through combined transoral 
and endoscopic marsupialization.