Operative Findings (Second Branchial Anomalies)

In this operative picture a circumcised opening leaving a fine border of skin becomes visible, grasped by a forceps at the top. This opening continues via a fistula to a large, yellowish mass (lateral cyst of the neck) and continues as a fistula up to the pharyngeal tonsil. The first transverse incision for the excision of the mass is located lower and is covered by the lateral cyst. The second transverse incision located higher is visible, lies underneath the angle of the lower jaw and is for the excision of the upper part of the duct. It is indispensable for a clear view, given the radical nature of the excision. There are several anatomical types of second branchial anomalies: The fistula may have a duct which continues cranially; it may end blind or continue with or without an intermediate cyst up to the pharyngeal tonsils. Or, there may be an isolated cyst which may or may not continue cranially into a blind-ending duct or into a duct up to the pharyngeal tonsil; $$tuha_24??nr=3££see alternate figure§§ .