ABSTRACT
Congenital malformations of the neck make up a wide range of pathological processes in children. They present as cysts or fistulas. A retrospective study was performed in order to present an overview of the relevant embryology, pathophysiology, epidemiology and diagnostic modalities for these anomalies. It describes a serial of 117 children treated for congenital cysts and fistulas of the neck between 1994 and 2006. The average age was 12 years. Malformations of the midline included the thyroglossal duct cyst [89 cases], dermoId cysts [7 cases], thymic cysts [2 cases] and cervical cleft in one case. The commonest malformations of the laterocervical region were cysts and fistulas of the 2nd cleft [10 cases], fistulas of the 3rd cleft [5 cases] then cystic hygroma [2 cases]; the 4th cleft fistula was found in only one case. All the patients undertook a surgical treatment except one who had sclerotherapy for an extended cystic lymphangioma. The complications of these malformations, especially infectious, do not result from a difficult management, which is well codified but from the diagnosis delay. An accurate preoperative diagnosis and appropriate surgical therapy are essential to prevent recurrence and to ensure optimal cosmetic outcomes