• A congenital cyst that presents in close relation to the parotid region, facial nerve, and external auditory canal - a remnant of the 1st branchial cleft (Mehmi et al. 2019)
• Typically located in the periauricular area (Fastenberg et al. 2016)
• Work type 1 cysts contain only ectoderm and are located preauricularly, tracking anteriorly/medially to the external auditory canal (Coste et al. 2023)
• Work type 2 cysts contain both ectoderm and mesoderm and are located at the angle of the mandible or submandibular region (Coste et al. 2023)
• Rare, with type II cysts more common than type I (Coste et al. 2023)
• On exam, typically smooth, non-tender, and fluctant mass
  • Otologic exam is important as there may be a connection to the middle or external ear (Coste et al. 2023)
• Most presentations occur in the first two decades of life (Mehmi et al. 2019), consider in the setting of recurrent parotid infections

Radiologic Findings

• On CT: Low density or isodense (if infected) without contrast; with contrast non-enhanching or mildly rim enhancing - stranding and enhancement if infected
• On MR: low signal on T1; high signal with potential sinus tract on T2; T1 post-contrast will be low signal unless recent or current infection