Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients.

A retrospective analysis of 183 patients undergoing surgical treatment for branchial cleft cysts and fistulae between 1970 and 1990 was carried out. There were 148 (80.8%) cases of branchial cleft cysts and 35 (19.2%) cases of branchial cleft fistulae. In patients with branchial cysts, the most frequent clinical presentation consisted of a left-sided, painless, cervical mass. Patients with a branchial fistula presented with persistent mucous discharge from a skin opening in the neck. The introduction of ultrasonography, computed tomography, and magnetic nuclear resonance imaging has improved the accuracy of traditional radiologic methods such as parotid sialography and fistulography. Complete excision under general anesthesia is the treatment of choice, and the procedure is associated with a low incidence of local complications and neurologic sequelae. The overall recurrence rate was 4.9% after a follow-up of 2 years.