Congenital Cervical Cysts, Sinuses and Fistulae

Distribution of branchial anomalies in a paediatric Asian population

“…(2,3) In contrast, first branchial cleft anomalies make up only 1% of these lesions, while third and fourth branchial arch anomalies account for 3%-10% of these lesions. (4)(5)(6)(7) These anomalies may occur as cysts, sinuses or fistulae.…”

Second Branchial Cleft Cyst

“…Other branchial anomalies exist but are much less common than second cleft anomalies which represent [95 % of all branchial cleft anomalies [1,2]. Second branchial cleft cysts are usually located in the lateral neck anterior to the sternocleidomastoid muscle.…”

“…Secondary infections and inflammation can occur. Although unusual, bilateral second branchial cleft cysts have been reported and in some patients this is part of the branchio-oto-renal syndrome, an autosomal dominant disorder [1]. Mapped to chromosome 8q 13.3, other symptoms include hearing impairment, cup-shaped pinnae, preauricular pits, branchial fistulae and renal anomalies.…”

“…The treatment for second branchial cleft cysts is surgical resection approached by a transverse cervical incision [1]. The cysts can be located either superficial or deep to the cervical fascia.…”

Selective Neck Dissection: A Novel Technique for Second Branchial Arch Anomalies

“…The tract can also be injected with methylene blue; however, this may extravasate and stain the surrounding tissues making dissection difficult. 16 One study concludes that in practice, identification of the tract is not difficult as these tracts are invested in a layer of striated muscle which makes them quite substantial and fairly easy to follow.…”