Cysts and sinuses of the lateral head and neck.

A series of 82 cysts and sinuses in the lateral head and neck has been reviewed with a view to features which may help to determine origin from the fetal branchial apparatus. Whilst both pre-auricular and lateral cervical sinuses are often hereditary and associated with other developmental anomalies, these features are lacking in the case of infra-auricular first cleft anomalies and lateral cervical cysts. Although salivary tissue occurred in 50 per cent of lateral cervical sinuses, only one of the cysts presented this feature. Lymphoid tissue was present in all lateral cervical cysts, but no sinusoids were found within the cyst wall. Lymph nodes were present in the majority of these specimens, but separated from the cyst wall by a fibrous layer. It is therefore unlikely that the cysts arise from salivary inclusions in cervical lymph nodes. The different clinical features would not support the view that lateral cervical cysts and sinuses have identical embryological origins.