Clinical presentation of BCA
Clinically, the majority of BCA present as a painless compressible
swelling, draining sinuses, or fistulae situated at the anterior border
of SCM in line between the mandibular angle and clavicle. [6]
Presenting patients may report a variety of duration and periods of
waxing and waning of the neck swelling. Acute size increase can occur
due to upper respiratory tract infections. [4] Secondary infections
and inflammation can occur, therefore neck abscesses are possible.
[7]
Although rare, bilateral second branchial cleft cysts have been reported
[8] and in some patients this is part of the branchio-oto-renal
syndrome (BOR), an autosomal dominant disorder. [9] BOR or
Melnick-Fraser-Syndrome [10] symptoms include hearing impairment,
cup-shaped pinnae, preauricular pits, branchial fistulae and renal
anomalies. [4] Even though there is a positive predictive value in
preoperative diagnosis of BCA, cystic neck masses should presumed
malignant. [11]