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Background and Objectives:The branchial anomaly is a lateral neck mas comonly sen by otolaryngologists. Although somewhat controversial, almost all surgeons agree that lateral cervical cyst, fistula and sinus are of branchogenic origin. Dep-study is to evaluate the clinical and pathologic manifestations of branchial anomaly and to determine proper diagnosis and treatment. Materials and Method:With a review of charts, we retrospectively analyzed 46 cases of the branchial anomaly who had been treated at the Hanyang University Medical Center between 1991 and 2001. Age, sex, site of lesion, classification, surgical therapy, radiologic and pathologic findings and post-operative surgical complications were reviewed. Results:The second branchial and sinuses were detected relatively at the younger age. Twenty five per cent of patients were presented in the infected state, and 45 cases were treated with complete surgical excision;there were no major post-operative complications and recurrence. Conclusion:An acurate diagnosis is crucial in the management of branchial anomaly to prevent recurrence and multiple sur-gical procedures. Although clinical examination and history are the most important factors suggesting the diagnosis of branchial anomaly, preoperative radiologic evaluation can be used to determine the nature and extent of the branchial anomaly. After (Korean J Otol-aryngol 2002;45:998-103 )