Branchial cleft cysts, arising from developmental anomalies of the branchial apparatus, represent a rare entity in adult populations. This case report presents a unique instance of a 32-year-old female with a second branchial cleft cyst prominently involving the great auricular nerve, an undocumented finding in the existing literature. The patient initially presented with progressive left-sided neck swelling, accompanied by localized pain radiating to the auricle and headaches, without systemic symptoms.
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