Branchial cleft cysts are small fluid-filled sacs that may look like lumps under your skin on the side of your neck. These cysts are congenital, meaning they’re present at birth. Branchial cleft cysts appear at any age but are often found in children. They’re benign (noncancerous), but healthcare providers may recommend surgery to remove the cyst.
Branchial cleft cysts are small fluid-filled sacs that may look like lumps under your skin on the side of your neck. Healthcare providers may refer to branchial cleft cysts as pharyngeal cleft cysts or as a type of neck mass.
These cysts are congenital, meaning they’re present at birth. Branchial cleft cysts appear at any age, but children are more likely than adults to be diagnosed with them. People can develop noticeable branchial cleft cysts later in life. This usually happens when the cysts are infected.
Branchial cleft cysts are benign, but healthcare providers may recommend surgery to remove the cyst to prevent or treat infections or recurrent (returning) swelling.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Healthcare providers aren’t sure if branchial cleft cysts are rare or common. That’s because not all branchial cleft cysts cause problems. That said, branchial cleft cysts are one of the most common forms of neck masses or lumps, especially in children.
Branchial cleft cysts happen during gestation, as your body is building the foundation for your head and neck structure, including your larynx (voice box), your mandible (upper jaw) and your hyoid bone, which supports your tongue.
Here’s how that process works:
Healthcare providers categorize branchial cleft cysts by the arch and cleft. Here is information about those types:
Branchial cleft cyst type | Incidence | Location and impact |
---|---|---|
First branchial cleft cyst | First branchial cleft cysts make up approximately 5% to 25% of all branchial cleft anomalies. There are two first cleft cyst sub-types. | First branchial cleft cysts are located between your ear and the submandibular area. That’s the area between your lower jaw and your hyoid bone. Your hyoid bone supports your tongue. First branchial cleft cysts can affect your middle or external ear. |
Second branchial cleft cyst | This is the most common branchial cleft cyst, representing approximately 40% to 95% of branchial anomalies. | These cysts usually appear under the skin of your neck muscle. People often notice second branchial cleft cysts when they develop upper respiratory infections. You can have second branchial cleft cysts on both sides of your neck. |
Third/fourth branchial cleft cysts | These cysts are rare. | They’re usually found under your skin on the left side of your neck or at the bottom of your neck near your collarbone. These cysts can affect your thyroid gland. |
Branchial cleft cyst type | ||
First branchial cleft cyst | ||
Incidence | ||
First branchial cleft cysts make up approximately 5% to 25% of all branchial cleft anomalies. There are two first cleft cyst sub-types. | ||
Location and impact | ||
First branchial cleft cysts are located between your ear and the submandibular area. That’s the area between your lower jaw and your hyoid bone. Your hyoid bone supports your tongue. First branchial cleft cysts can affect your middle or external ear. | ||
Second branchial cleft cyst | ||
Incidence | ||
This is the most common branchial cleft cyst, representing approximately 40% to 95% of branchial anomalies. | ||
Location and impact | ||
These cysts usually appear under the skin of your neck muscle. People often notice second branchial cleft cysts when they develop upper respiratory infections. You can have second branchial cleft cysts on both sides of your neck. | ||
Third/fourth branchial cleft cysts | ||
Incidence | ||
These cysts are rare. | ||
Location and impact | ||
They’re usually found under your skin on the left side of your neck or at the bottom of your neck near your collarbone. These cysts can affect your thyroid gland. |
Many branchial cleft cysts don’t have symptoms. That’s why healthcare providers can’t say if these cysts are common. But when branchial cysts do cause problems, some symptoms you might notice include:
Healthcare providers will examine your neck and ask about your symptoms. They may do the following radiology studies:
Yes. Even if your cleft cyst isn’t causing problems, your healthcare provider will likely recommend surgery to remove your cyst and eliminate the chance of your cyst becoming infected.
Each branchial cleft cyst type might require different treatment. Some potential treatments your healthcare provider may recommend include:
No, these cysts are congenital conditions, meaning you were born with them.
Surgery to remove your cyst usually solves the problem. Very few branchial cysts recur, or come back, after being surgically removed.
If you’ve had surgery to remove a branchial cleft cyst, your healthcare provider will give you specific instructions on caring for your surgery site. You should contact your healthcare provider if:
Children and adults can have branchial cleft cysts that cause painful symptoms. If you or your child have these cysts, some questions you may want to ask your healthcare provider include:
A note from Cleveland Clinic
It may be unnerving to find an unusual lump on your or your child’s neck, even if the lump doesn’t hurt. Many times, mysterious lumps turn out to be cysts, such as branchial cleft cysts that are benign and that your healthcare provider can remove surgically. Talk to your healthcare provider any time you notice a lump on your neck or your child’s neck. They’ll diagnose the problem and recommend treatment.
Last reviewed by a Cleveland Clinic medical professional on 03/17/2022.
Learn more about our editorial process.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy