A 25-year-old man presents with a painless, slowly enlarging lateral neck mass at the angle of the jaw. FNA shows squamous epithelium with lymphoid tissue. A branchial cleft cyst is suspected. Which branchial cleft anomaly is the MOST common, and where is it typically located?
- A Second branchial cleft; anterior border of sternocleidomastoid at the angle of the jaw ✓
- B First branchial cleft; near the ear or parotid
- C Third branchical cleft; lower anterior neck
- D Fourth branchial cleft; left lower neck near the thyroid
Correct answer: A. Second branchial cleft; anterior border of sternocleidomastoid at the angle of the jaw
Explanation
Second branchial cleft anomalies are the most common (90-95% of branchial cleft anomalies). They typically present as a cyst or sinus along the anterior border of the sternocleidomastoid muscle, near the angle of the jaw. First branchial cleft anomalies are rare and associated with the ear/parotid. Third and fourth are very rare. This is a high-yield ENT topic for exams.
Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.