Postoperative Outcomes of Branchial Cleft Cyst Excision in Children and Adults: An NSQIP Analysis

Objective: Identify risk factors and perioperative morbidity for patients undergoing branchial cleft cyst (BCC) excision. Study Design: Cross-sectional analysis. Setting: American College of Surgeons National Surgical Quality Improvement Program adult and pediatric databases (NSQIP and NSQIP-P). Subject and Methods: Patients who underwent BCC excision (Current Procedural Terminology 42810, 42815) were queried via NSQIP (2005-2016) and NSQIP-P (2012-2016). Outcomes analyzed include patient demographics, medical comorbidities, admission type, operative characteristics, length of hospital stay, postoperative complications, and readmission. Results: A total of 1775 children and 677 adults were identified. Mean age at time of surgery was 4.6 years for children and 38.6 years for adults. Outpatient procedures were performed in 87.1% of adults and 94.0% of children (P <.001). Postoperative complications were uncommon, occurring in <1% of adults and 3.9% of children (P <.001). Similarly, readmission occurred in 1.2% of adults and 1.1% of children. In adults, smoking status was shown to have a significant effect on postoperative complications (odds ratio, 6.25; P =.037). Age group did not have an effect on the complication rate in the pediatric population. Pediatric otolaryngologists had higher rates of postoperative complications (P =.001), prolonged operative times (P <.001), and fewer outpatient procedures (P <.001). Conversely, in adults, otolaryngologists had fewer postoperative complications. Conclusion: Postoperative complications following BCC excision are relatively uncommon, demonstrating procedural safety when performed at any age.