Cysts and Sinuses of the Head and Neck

  • Overview

    Cysts and sinuses of the head and neck include a variety of soft, usually non-tender benign lumps or masses that are congenital (developed prior to birth) and are found below the skin (subcutaneous) in different locations on the face, scalp, neck or ear.

    How Children's approaches cysts and sinuses of the head and neck

    The General Pediatric Otolaryngology Program at Boston Children's Hospital provides care including diagnostic evaluation and surgical therapy for children of all ages with diseases or conditions of the head and neck, including the ears, nose, and throat.

    Cysts and sinuses of the head and neck

    Boston Children's Hospital 
    300 Longwood Avenue
    3rd Floor
    Boston MA 02115


  • In-Depth

    While most cysts and sinuses will never pose a health risk to your child, some can become infected and must be surgically removed. Some can become the site for cancer in adults, and others can be surgically removed for cosmetic

    Types of cysts and sinuses:

    Dermoid cyst

    • A dermoid cyst is a slow-growing mass most often found on the scalp, face (usually beneath the eyebrow or near the bridge of the nose) or the neck.
    • This kind of cyst (a cyst is an isolated mass with no drainage tracts) grows progressively. Your child's doctor will refer you to a pediatric surgeon for further evaluation.
    • If the dermoid cyst is located on your child's scalp, the surgeon will to see whether it extends through the cranium. For that reason, a child with a dermoid cyst on the scalp will probably undergo an x-ray of the skull.
    • Dermoid cysts, because of their nature to grow progressively, should be removed surgically.

    Preauricular sinus or skin tags

    • A preauricular sinus is a little tube located where the upper part of the ear's auricle (the outside part of the ear) joins the head. (A sinus is a saclike structure with a single drainage site). A skin tag is a tiny mass of skin in the same location.
    • The preauricular skin tag can be surgically removed for cosmetic reasons and the sinus should be removed if an infection has

    Neck lumps

    • A neck lump may be located anywhere from the top of the neck, in front of or behind an ear, to the bottom of the neck, just above the collarbone. The most common of these is an enlarged lymph node (a small pea-sized knot of tissue that produces lymphocytes, a type of white blood cell typically infected or enlarged due to reaction to an infectious agent.)
    • Enlarged lymph nodes, which are usually harmless, are referred to as lymphadenitis. Lymphadenitis is produced by bacteria, cat scratch fever, and even atypical tuberculosis.
    • If your child's doctor is concerned, he/she may prescribe antibiotics or if the lump appears worrisome, may refer your child to a pediatric surgeon to have a biopsy (removal and analysis of a tissue sample from the lump).
    • Another type of neck lump is a branchial cleft cyst or sinus. They generally change in size and shape and are often first detected after an upper respiratory tract infection, which causes enlargement of the mass. Branchial cleft cysts or sinuses should be removed to assure the diagnosis, improve appearance, prevent infection, and prevent it as being a site for a potential cancer in adulthood.
    • A thyroglossal duct cyst, a mobile, soft nontender, round swelling, is also found in the center of the neck.
    • Your child's doctor will probably want to have this kind of a cyst and its underlying attachment to the hyoid bone (located at the base of the tongue to support the tongue) surgically removed to prevent infection or potential malignancy.
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