BRANCHIAL CLEFT CYST;

Background: Branchial cleft cyst is rare congenital anomaly and most common cause of head and neck pathology in children. Second branchial cyst accounts 95 % of the all brnchial anomalies. It mostly manifest in 2nd and 3rd decade of life. Early diagnosis, controlling the infection status and complete excision without nerve injury is mainstay of treatment. Recurrence rates is very low after complete surgical excision. Study Design: Retrospective study. Setting: Department of Otolaryngology, Head and Neck Surgery, Benazir Bhutto Hospital Rawalpindi. Period: 02 year from August 2016 to July 2018. Methods: 04 cases of branchial anomalies. Age, sex, and duration of symptoms were noted from the case records. The side and site of the lesion and the site of opening of sinuses and fistula were noted. The cystic lesions were investigated with ultrasound and CT scan. Surgical excision of cyst and sinus done. Results: The structure of the studied group was as follows: the ratio men/women was of approximately 3/1; the ratio branchial cysts/branchial sinuses/branchial fistulae = 2/2/0.  Age ranged from 16 to 27 years. Two patients presented with left neck swelling and one patient presented with right neck swelling and one with right sided discharging sinus. Complete surgical excision was done in all cases and no complication occured. Conclusion: Branchial cysts are commonly misdiagnosed and rarely included in the differential diagnosis. Physician should suspect in any patient with a swelling in the lateral part of the neck.