Transoral robotic surgery for removal of a second branchial arch cyst: a case report.

Second branchial arch cysts are a common cause of cystic neck mass in adults. The type-IV variant of the second branchial arch cyst is uncommon and presents as a parapharyngeal space mass. It lies medial to the carotid sheath and it is not easily amenable to access by the traditional, trans-cervical approach to the parapharyngeal space. Trans-oral robotic surgery is a new application of the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). The system has only recently been approved by the FDA for trans-oral robotic resection of oropharyngeal cancers. The technology has since been used for new trans-oral applications, including resection of parapharyngeal space tumours. This is a case report of successful trans-oral robotic resection of a type IV second branchial arch cyst in the parapharyngeal space.