A systematic literature review to compare clinical outcomes of different
surgical techniques for second branchial cyst removal.
Abstract
Aims: During the last two decades, new treatment methods have been
developed for the surgical removal of second branchial cysts which
result in less visible scars. The aim of this systematic review is to
assess which surgical technique for second branchial arch cyst removal
results in the lowest complication and recurrence rates with the highest
scar satisfaction. Methods: Two authors systematically reviewed
literature in the Cochrane, PubMed and EMBASE databases (search date:
1975 to December 23th, 2019) to identify studies comparing surgical
outcomes of second branchial arch cyst removal. Authors appraised
selected studies on directness of evidence and risk of bias. Results are
reported according to Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) statement. Results: Out of the 2101 retrieved
articles, four articles were included in the current review including a
total of 140 operated cysts. Only two studies included pre-operatively
infected cysts. Follow up ranged from 3 to 24 months. Complication rates
ranged between 0 to 27.3% (conventional: [0-10.4%];
endoscopic/retro auricular: [0-27.3%]). None of the patients
presented with postoperative recurrence. Significantly higher scar
satisfaction was found in adult patients who underwent endoscopic or
retro-auricular hairline incision cyst removal. Conclusion: No
recurrence of disease occurred during (at least) 3 months of follow up
using either conventional surgery or endoscopic/retro auricular
techniques. Although more (temporary) complications occur using
endoscopic and retro-auricular techniques, patients report a
significantly higher scar satisfaction 3 to 6 months after surgery in
comparison to the conventional technique. Future studies are needed to
support these findings.