Congenital Cystic Lesions of the Head and Neck

om Congenital cervical cystic masses comprise an uncommon group of lesions that is usually encountered during infancy and childhood. The prevalence of these lesions varies from common (thyroglossal duct cysts, branchial cleft cysts, and cystic hygromas) to very rare (thymic and cervical bronchogenic cysts). The absolute number remains unknown. Thyroglossal duct (TGD) cysts are the most common mass found in the midline of the neck in children. Anomalies of the branchial apparatus include branchial, thymic, and parathyroid anomalies, which may manifest as cysts, sinuses, fistulae, and ectopic glands. Clinical history and physical examination of the patient are important elements in the evaluation of a suspected congenital neck mass (Table 1). Familiarity with the embryology and anatomy of the cervical region frequently allows the differential diagnosis to be narrowed. Congenital cervical cystic lesions are usually slow-growing masses and typically cause symptoms only due to enlargement or infection. A painless soft or fluctuant cervical mass is the first clinical manifestation in most cases. Following physical examination, ultrasonography (US) is usually performed. US helps to confirm the cystic nature of the lesion and extent of the mass, and to demonstrate its relationship to surrounding normal structures. Computed tomography (CT) also provides this information,