Conservative surgical treatment of pharyngeal branchial cyst.

The parapharyngeal presentation of a branchial cleft cyst of the second arch is extremely uncommon. The treatment considered to be most effective is total extirpation via a transcervical approach, but this is not without its complications. A case is described here of a patient who requested conservative treatment. Thus, a transoral exeresis of the oropharyngeal wall of the cyst was carried out, the cyst was drained, and its borders were marsupialized to the pharyngeal wall. Postoperative evolution was towards obliteration of the tract, as should have occurred in the embryonal period.