Congenital Cervical Cysts and Fistulas

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Abstract
Median and lateral cervical cysts and fistulas are fairly frequent developmental anomalies. A material consisting of 45 operated patients is presented. As a rule, median cysts are easily diagnosed, whereas greater differential diagnostic problems appear when it is a question of lateral, branchiogenic cysts; particularly so, because their symptoms may occur relatively acutely and in any age-group, even in extreme old age. We found that the safest method of determining the diagnosis of branchiogenic cyst was demonstration of squamous epithelial cells in the cyst fluid. The examination showed positive results in 90% of the patients examined by this method. In all cases complete surgical extirpation was carried out. When it is a question of median cysts, the body of the hyoid bone should be removed in any case, since otherwise the risk of recurrence is very great. One case of branchiogenic cyst showed malignant changes in the epithelial lining of the cyst, without any other clinical or macroscopical signs of malignancy; extirpation must therefore be recommended in any case, even when subjective symptoms of the patient are negligible.

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