The most common third branchial apparatus anomaly is the thymic cyst.
When off midline, branchial apparatus cysts and lymphatic malformations should be considered.
Meanwhile Papay and colleagues reported a case of nasopharyngeal branchial cleft and explained that its embryological origin was from the most lateral portion of the 2nd branchial apparatus
. (1,2) Second arch branchial cysts were classified by proctor into 4 types:
(1.) Benson MT, Dalen K, Mancuso AA, et al: Congenital anomalies of the branchial apparatus
: Embryology & pathologic anatomy.
Given the complex anatomy of the head and neck, along with the fact that most structures located between the upper aerodigestive tract internally and the skin of the neck externally are derived from the branchial apparatus
, it stands to reason that anomalies can present almost anywhere between these two boundaries.
Von Baer initially described the existence of the cervical branchial apparatus
in 1827, and within 5 years, this structure's association with branchial fistulas was recognized.
Anomalies of the branchial apparatus
occur with some frequency in the adult and pediatric populations.
The branchial apparatus
develops during the third to seventh weeks of intrauterine life.
It has been estimated that 95% of branchial apparatus
congenital anomalies are derived from the second arch, pouch, and cleft.
The first suggests that they are derived from the branchial apparatus
.  The second theory considers the presence of subepithelial lymphocytes and suggests that the cysts are derived from ectopic epithelial cells in the regional lymph nodes.
According to the branchial apparatus
theory, type IV cysts arise from a remnant of an internal pharyngeal duct, which would indicate that they are endodermal.
Acute suppurative thyroiditis and the branchial apparatus
. Am J Otolaryngol 1991;12:6-l1.