Branchial cleft anomalies and thymic cysts.

Branchial cleft anomalies are a common cause of congenital neck masses and can present as a cyst, sinus, or fistula. A comprehensive understanding of the embryologic basis of these anomalies aids in diagnosis and surgical excision. Fistulas tend to present at an earlier age than sinuses or cysts, with most lesions presenting as either a neck mass, draining sinus, or recurrent infections. The eventual management of each is complete surgical excision, which is curative. A history of recurrent preoperative infections leads to a higher rate of recurrence.