Second Branchial Cleft Cyst

  • Etiology: remnant of embryonal branchial arch incompletely obliterated, courses from posterior to submandibular gland and anteromedial to sternocleidomastoid muscle and lateral to carotid space
  • Imaging: look between sternocleidomastoid muscle and submandibular gland
  • US: internal debris may look more solid
  • CT: low density, notch sign (cyst extension between internal carotid artery / external carotid artery bifurcation), if it has thick wall or contrast enhancement think infection
  • MRI: T1 hypointense, T2 hyperintense, no contrast enhancement
  • Clinical: 90% of branchial cleft cysts

Cases of Second Branchial Cleft Cyst