Endoscope-Assisted Excision of Second Branchial Cleft Cysts Using a Hairline Approach in the Posterior Occipital Region

PurposeSecond branchial cleft cysts have usually been resected through a prominent incision over the entire protruding zone. The resultant scar can be esthetically displeasing. We report on the endoscope-assisted excision of second branchial cleft cysts by way of a posterior occipital approach. We explored the feasibility, validity, and safety of this procedure.Materials and MethodsFrom November 2008 to February 2011, 8 patients with second branchial cleft cysts underwent endoscope-assisted resection by way of a posterior occipital approach using an endoscopic technique.ResultsAll the procedures were successfully performed using endoscope-assisted surgery by way of a posterior occipital approach with an operative time of 70 minutes (range 60 to 110) and a bleeding volume of 10 mL (range 5 to 15). No postoperative complications, such as injury to the great auricular nerve, occurred and no operative conversions were required. The average follow-up period was 42.6 months (range 35 to 61), without any symptoms. All the patients and their families were satisfied with the cosmetic results.ConclusionsEndoscope-assisted excision of second branchial cleft cysts by way of a posterior occipital approach could be applied effectively, safely, and feasibly, allowing adequate exposure for dissection and providing good cosmetic results. Thus, it should be considered as an alternative surgical approach for these patients.