Clinical Features of Remnants of the Second Branchial Pouch and Cleft

Second Branchial	Derivative
arch	stapes, styloid process, root of tongue, lesser horn and part of body of hyoid bone, foramen secum, medan anlage of thyroid gland
pouch	palatine tonsil, supratonsilar fossa

 

Type of lesion:

(1) cyst (mobile, painless swelling)

(2) sinus emptying into the pharynx (may swell if drainage is poor or if food and fluid accumulate)

(3) sinus emptying onto the skin surface

(4) fistula

 

The lesion may involve:

(1) lower third of the neck anterior to the border of the sternocleidomastoid muscle

(2) carotid sheath and/or bifurcation of the carotid arteries

(3) upper half of the posterior tonsillar pillar or tonsil itself

 

Lining of the lesion:

(1) ciliated epithelium

(2) stratified squamous epithelium

(3) lymphoid tissue in wall