Reappraisal of lateral cervical cysts in neonates: pyriform sinus cysts as an anatomy-based nomenclature.

BACKGROUND/PURPOSE: Cervical cysts in neonates are recognized as rare branchial remnants. This term includes many different derivatives of the branchial cleft and sinus.

METHODS

A retrospective review was performed in seven neonates with lateral cervical cysts seen at a single institution between 1975 and 1996. Two patients underwent simple excision of the cyst before 1987. Since 1987, five underwent complete excision of the sinus with or without esophagoscopic assistance to identify the orifice of the pyriform sinus.

RESULTS

All of the cysts were located on the left side of the neck, anterior to the sternocleidomastoid muscle. Five had large cysts containing air. In four patients, a large orifice of the pyriform sinus was identified by the esophagoscopy. In six of seven patients, the histological examination showed thyroid or thymic tissue in the wall of the cysts, which is compatible with a clinical entity of "pyriform sinus fistula" commonly seen in older children.

CONCLUSION

We propose that this anomaly be called a pyriform sinus cyst, which is an anatomic term based on their draining orifice.