Largely as a result of the historic work of Rathke1 in 1825 on the development of structures of the head and neck from the embryonic branchial system, many hitherto unexplained anomalies of this region of the body have been better understood. Rathke noticed the similarity of the piscine gill system to the embryonic cervical structures of man, the pig, horse and chick. Other investigators followed Rathke and in rapid succession correctly related the embryonic to the normal postnatal anatomy. That congenital anomalies of the face and neck were soon interpreted as the effects of early embryonic maldevelopment is apparent. Heusinger,2 for example, in 1864 analyzed forty-six cases of cervical and facial malformations and was well aware of their origin.
The most common defect of the branchial system in the neck of man is the lateral cervical cyst or fistula. Among the rarer defects is the presence of cartilaginous