Literature course based on:

Insights into the Imaging article: "Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings."

Key points:
• Anomalies of the branchial arches usually present as cysts, sinuses or fistulae.
• Second branchial arch anomalies account for approximately 95 % of cases.
• There are no pathognomonic imaging features so diagnosis depends on a high index of suspicion and knowledge of typical locations.
• Persistent cysts, fistulae or recurrent localised infection may be due to branchial arch anomalies.
• Surgical excision of the cyst or tract is the most common curative option.