ABSTRACT
Cysts, sinuses, and fistulas of the neck derived from branchial cleft remnants are common in the pediatric age group. Although all are present at birth, sinuses and fistulas are encountered more commonly in infants and children, while branchial cysts present more often in older children
and young adults. Remnants of the first and second branchial apparatus are most common, accounting for 96 percent of all branchial anomalies with abnormalities of the second cleft outnumbering those of the first by 6:1. Abnormalities of the third and fourth branchial apparatus are rare, but recent case reports and reviews indicate that they may be more common than previously supposed.
