[Third and fourth cervical pouches remnants and branchial clefts]

We present our experience with nine patients who were operated on for having cervical cysts lesions with the purpose of providing more information about this type of pathology. Five patients presented a left low-jaw cervical mass, diagnosed in the neonatal period. All of them presented with respiratory distress and in four of them quick local inflammatory manifestations appeared. A plain radiograph demonstrated liquid and air in the lesion and we proceeded to the operation. We made four drainages with marsupialization and in another patient complete excision of the lesion was made. Two marsupializations closed spontaneously and the other two had to be reoperated for excision of a pharyngo-cutaneous fistula. In the wall of the cyst there were thyroid-follicles, considering them remnants from the fourth branchial pouch. Three patients were diagnosed at one, two and five years of age respectively with a cervical mass and were operated on with complete excision. Due to its anatomic situation and lack of relation with other structures, we thought as probably deriving from the cervical sinus. In one patient who presented a mass in the inner side of the sternocleidomastoid muscle, complete excision of the lesion was made which had a tract joining the piriform sinus area, and thymic and thyroid tissue, being diagnosed as a cervical thymic cyst. All the patients cured with the complete excision. The anatomic situation ot these lesions and their connexions with next structures provide the best data to know their probable embrionary origin.