Anomalies of the branchial apparatus

Developmental abnormalities of the branchial apparatus represent a common cause of congenital lateral neck mass. Most often this is seen in the pediatric population but certainly may present at a much later age. The branchial apparatus contributes to major development of the head and neck, and a thorough understanding of embryology and anatomy is essential in treating these patients. Branchial anomalies may present as a cyst, sinus, or fistula; infection frequently complicates successful long-term management. Most often these lesions can be diagnosed by thorough history and physical examination. Complete surgical excision is the treatment of choice; however, recurrences may be encountered especially in those patients with a history of prior surgery or local infection.