Excision of branchial cysts

Branchial cleft anomalies are uncommon findings that are often confused with other causes of masses and infections in the neck. Although more common in children, they may also present in adults. Second cleft anomalies are 8-10 times more common than those of the first. Third and fourth cleft anomalies are quite rare. All offending epithelium must be surgically removed. A thorough understanding of the embryologic origin, presentation, diagnostic evaluation, and surgical treatment of these challenging lesions will help the head and neck surgeon to a good outcome.