The branchial apparatus develops during the second to sixth weeks of fetal life. The first branchial cleft develops into the external auditory canal. First branchial cleft cysts are subdivided base upon location: type I cysts are located near the external auditory canal usually inferior, posterior and medial to the tragus/pinna.

All types of 1st branchial cleft cysts are intimately associated with the facial nerve and the parotid gland. Clinical manifestations range from a palpable mass to those associated with infection.

The main differential diagnostic consideration in our case is a lymphatic malformation.