Retroauricular Hairline Approach for Excision of Second Branchial Cleft Cysts

Objective: To report our preliminary experience with a retroauricular hairline incision (RAHI) for excision of second branchial cleft cysts (SBCC) and to present a relevant literature review. Study design: Retrospective case series. Methods: A retrospective chart review was conducted of two consecutive patients diagnosed with SBCC who underwent surgical removal via a RAHI. Relevant demographic, clinicopathological and radiological data were recorded. A web-based search was conducted to identify relevant scientific literature on "retroauricular hairline incision/approach" in order to present a systematic review of current literature. Results: In both cases, the SBCC (6.0 and 3.8 cm) could be safely excised without major complications. One patient developed a temporary hypoesthesia of earlobe. None of the patients had a postoperative infection, hematoma, spillage of cyst fluid or necrosis of the skin flap. All patients were satisfied with the cosmetic outcome of the procedure (100%). The incisions healed well without any evidence of hair loss or keloid formation. Conclusion: In conclusion, the RAHI offers an excellent surgical outcome and superior cosmetic result with no proven increased risks to the patients who require surgical excision of a benign SBCC.