ABSTRACT

This chapter discusses the best management of congenital cysts and sinuses of the neck, none of which is based on randomized controlled trials or meta-analyses, but rather single-surgeon, single-centre large case series or systematic review. Branchial anomalies usually present as lateral neck masses with infection, cyst enlargement or an intermittently draining sinus. Treatment usually involves surgical excision with identification and preservation of nearby neurovascular structures. Thyroglossal duct cysts are the most common congenital abnormality in the head and neck region. Lingual thyroid is the result of failure of descent of the thyroid anlage from the foramen caecum of the tongue. Depending on size, lingual thyroid can present with dysphagia, airway obstruction, haemorrhage or endocrine dysfunction. More often the patient is completely asymptomatic with suspicion only after other investigations, following routine ENT examination or detected on parental curiosity.