Fifty-three cases of congenital cervical cyst and fistula, including 38 cases of thyroglossal duct cysts, 12 of branchial cleft fistulas, and 3 of pyriform sinus fistulas are reported. There were 24 males and 29 females. The age of the subjects at the time of the operation varied from 5 months to 70 years, and 64 percent of the cases were less than 15 years old.
Thirty cases (79%) of thyroglossal duct cyst and 7 cases (58%) of branchial cleft fistula occurred up until the age of 15. The main symptoms were a cystic mass in the former, and fistulas in the latter. Signs of infection were found in 14 cases (37%) of the former, and in 4 cases (33%) of the latter.
Three pyriform sinus fistulas emerged as cervical abscesses, acute suppurative thyroiditis and mediastinal abscesses. In one case that could not be diagnosed by the usual pharyngoesophagography, and in confirming a comunication tract of the fistula during surgery, fistulography with a rigid bronchoscope proved to be useful diagnosis method.
The most important task in the operative therapy of congenital cervical cysts and fistulas is to prevent a relapse of the disease. Therefore, a reliable operation based on accurate anatomical knowledge is required.