The definitive treatment for branchial cleft anomalies is complete surgical removal. Branchial cysts that are incompletely removed can recur. If an acute infection is present, antibiotic treatment is given before the operation.
Sometimes the tract of the branchial cleft anomaly extends to the back of the throat. In this case, endoscopic imaging through the mouth may be needed in order to remove the remnant of the tract completely. If this tract extends into the tonsil bed, a tonsillectomy may also be required.
Operations on the neck always involve some risks, as the work is done close to many important structures such as blood vessels and nerves, but thanks to experienced surgeons most are carried out without complications.
The greatest risk is recurrence of the cyst. It recurs if the branchial cleft remnant is not removed in its entirety. In the vast majority of patients, the cyst is successfully removed in a single procedure and no further problems are ever experienced.
The great vessels of the neck, that is, the main arteries and veins in the neck, are usually closely associated with the wall of the branchial cleft anomaly. Great care must be taken to separate them from the cyst and protect them; otherwise they may be injured.
In addition, the nerve that moves the tongue, the nerve that moves the vocal cords, the nerve that moves the lower part of the face and the nerve that allows us to raise our shoulders all pass very close to the operating field. Injury to these nerves is rare in this procedure, but because of their location there is a possibility of injury.