Clinical study on the congenital neck masses and fistulas

A clinical study was conducted of patients with congenital neck masses and fistulas treated surgically in the Department of Otolaryngology, Niigata University School of Medicine between 1981 and 1992. There were 37 cases (male : 22, female :15), which occupied 0.85% of all 4, 340 hospitalized patients. Ages ranged from 4 months to 81 years old, and the median age was 26 years old. In 15 cases, ages were below 20 years old, and in 22 cases, over 20 years old, indicating that the number of patients over 20 years old was not small. There were three cases of first branchial fistula, one case of second branchial fistula, 11 cases of lateral cervical cyst, four cases of pyrif orm sinus fistula, 12 cases of cervical median cyst, two cases of ectopic thyroid gland, three cases of cystic hygroma, and one case of benign infantile hemangioendothelioma of the parotid gland. When congenital diseases were considered in the differential, diagnosis was generally easy from anamnesis and local findings. Efficient radiological examination was important for immediate differentiation in the diagnosis. Essential treatment was complete surgical removal of the lesion. Aspiration and/or open biopsy should be avoided whenever possible.