Lateral cervical anomaliew and salivary heterotopia

It is widely accepted that most lateral cervical fistulas with an external opening in the suprasternal region orginate from second branchial arch remnants. Lateral cervical cysts occur higher in the neck and according to current theories, may develop either from the branchial apparatus or from glandular inclusions in cervical lymph nodes. An histological study revealed salivary tissue in 9 of 24 fistulas, 5 of these representing a congenital cervical salivary sinus, while only one of 17 cysts showed salivary heterotopia. This investigation indicates that salivary tissue may occur more commonly in the lateral neck than is generally realised, and that lateral cervical cystis and fistulas probably differ in their histogenesis.