\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[T2A]{fontenc}
\usepackage[romanian,ngerman,polish,english]{babel}



\usepackage{float}








\begin{document}

\title{A systematic literature review to compare clinical outcomes of different
surgical techniques for second branchial cyst removal.}



\author[1]{Sebastiaan Meijers}%
\author[2]{Rutger  Meijers}%
\author[3]{Erwin van der Veen}%
\author[4]{Maaike van den Aardweg}%
\author[5]{Hanneke Bruijnzeel}%
\affil[1]{UMC Utrecht}%
\affil[2]{Radboudumc}%
\affil[3]{Central Military Hospital}%
\affil[4]{Ziekenhuis Rivierenland}%
\affil[5]{Utrecht Medical Center}%


\vspace{-1em}



  
  \date{May 25, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Aims: During the last two decades, new treatment methods have been
developed for the surgical removal of second branchial cysts which
result in less visible scars. The aim of this systematic review is to
assess which surgical technique for second branchial arch cyst removal
results in the lowest complication and recurrence rates with the highest
scar satisfaction. Methods: Two authors systematically reviewed
literature in the Cochrane, PubMed and EMBASE databases (search date:
1975 to December 23th, 2019) to identify studies comparing surgical
outcomes of second branchial arch cyst removal. Authors appraised
selected studies on directness of evidence and risk of bias. Results are
reported according to Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) statement. Results: Out of the 2101 retrieved
articles, four articles were included in the current review including a
total of 140 operated cysts. Only two studies included pre-operatively
infected cysts. Follow up ranged from 3 to 24 months. Complication rates
ranged between 0 to 27.3\% (conventional: {[}0-10.4\%{]};
endoscopic/retro auricular: {[}0-27.3\%{]}). None of the patients
presented with postoperative recurrence. Significantly higher scar
satisfaction was found in adult patients who underwent endoscopic or
retro-auricular hairline incision cyst removal. Conclusion: No
recurrence of disease occurred during (at least) 3 months of follow up
using either conventional surgery or endoscopic/retro auricular
techniques. Although more (temporary) complications occur using
endoscopic and retro-auricular techniques, patients report a
significantly higher scar satisfaction 3 to 6 months after surgery in
comparison to the conventional technique. Future studies are needed to
support these findings.%
\end{abstract}%



\sloppy


\textbf{Manuscript title:} A systematic literature review to compare
clinical outcomes of different surgical techniques for second branchial
cyst removal.

\emph{Running title} : surgical branchial cyst removal

\textbf{External funding} : none\textbf{Data available:} on
request\textbf{Conflict of interest} : no conflict of interest to
declare

\textbf{Word count: Abstract:} 247 words, \textbf{Article:} 2426 words

\textbf{Level of Evidence:} Level IIA

\textbf{5 key points} :

\begin{itemize}
\tightlist
\item
  Branchial cysts are the most common branchial anomalies in adults and
  early and complete surgical excision is the recommended treatment
\item
  More (temporary) complications occur using endoscopic and
  retro-auricular techniques {[}0-27.3\%{]} than through application of
  the conventional technique {[}0-10.4\%{]}.
\item
  Retroauricular and endoscopic surgery results in significantly higher
  scar satisfaction in uninfected branchial cysts 3 to 6 months after
  surgery in comparison to the conventional technique
\item
  No disease recurrence was reported during (at least) 3 months of
  follow up using either conventional surgery or endoscopic/retro
  auricular techniques
\item
  Since follow up was short, recurrence rates could be underreported and
  scar judgment could be affected. Therefore, no evidence based
  treatment advice can be provided and future prospective studies with
  long-term follow up (\textgreater{} five years) are indicated.
\end{itemize}

\textbf{Abstract: Aims} : During the last two decades, new treatment
methods have been developed for the surgical removal of second branchial
cysts which result in less visible scars. The aim of this systematic
review is to assess which surgical technique for second branchial arch
cyst removal results in the lowest complication and recurrence rates
with the highest scar satisfaction.\textbf{Methods:} Two authors
systematically reviewed literature in the Cochrane, PubMed and EMBASE
databases (search date: 1975 to December 23th, 2019) to identify studies
comparing surgical outcomes of second branchial arch cyst removal.
Authors appraised selected studies on directness of evidence and risk of
bias. Results are reported according to Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) statement.

\textbf{Results:} Out of the 2101 retrieved articles, four articles were
included in the current review including a total of 140 operated cysts.
Only two studies included pre-operatively infected cysts. Follow up
ranged from 3 to 24 months. Complication rates ranged between 0 to
27.3\% (conventional: {[}0-10.4\%{]}; endoscopic/retro auricular:
{[}0-27.3\%{]}). None of the patients presented with postoperative
recurrence. Significantly higher scar satisfaction was found in adult
patients who underwent endoscopic or retro-auricular hairline incision
cyst removal.

\textbf{Conclusion:} No recurrence of disease occurred during (at least)
3 months of follow up using either conventional surgery or
endoscopic/retro auricular techniques. Although more (temporary)
complications occur using endoscopic and retro-auricular techniques,
patients report a significantly higher scar satisfaction 3 to 6 months
after surgery in comparison to the conventional technique. Future
studies are needed to support these findings.

\textbf{INTRODUCTION}

Second branchial cysts (SBCs) are the most common second branchial arch
anomalies (SBAAs) in adults whereas sinuses, fistulas and cartilaginous
remnants are in children (1--3). The branchial arches consist of clefts
and pouches and are the embryological precursors of the face, neck and
pharynx. In total, six pairs of branchial arches form on either side of
the pharyngeal foregut. Incomplete obliteration of these arches can lead
to formation of branchial anomalies, of which the SBAA represent up to
95\% of the cases (2). The second branchial arch forms part of the hyoid
and surrounding structures of the head and neck, while the second
branchial pouch shapes the palatine tonsil and the supratonsillair fossa
(1). Therefore SBAAs can occur anywhere along the course of the second
branchial arch tract that extends from the skin overlying the
supraclavicular fossa up to the pharynx at the level of the tonsillar
fossa (2).

In adults, when encountering an unilateral swelling of the neck, a
cystic metastasis of head and neck cancer should always be excluded
before SBC diagnosis can be confirmed (4,5). Since SBCs are prone to
recurrent infections and do not dissolve spontaneously, early and
complete surgical excision is the recommended treatment (1,6). Different
surgical techniques for SBC removal have been proposed. Traditionally,
conventional surgery using a large cervical incision was used to ensure
complete removal (7). However, the large cervical incision results in a
prominent scar. In an attempt to reduce visible scars, newer techniques
have been developed, such as endoscopic surgery (6,8--10) and the use of
a retro-auricular hairline incision (RAHI) (11--13). RAHI can be
performed either as an open procedure using a `facelift' incision or as
an endoscopic technique. To provide insight in the optimal surgical
management of patients presenting with a SBC, this systematic review
evaluates which surgical technique (conventional, endoscopic or RAHI)
for SBC removal results in the lowest recurrence and complication rates
with the highest scar satisfaction.

\textbf{METHOD}

\textbf{Identify relevant studies and study selection} A systematic
literature search was conducted on the 23th of December 2019, in the
PubMed, Cochrane and EMBASE databases to identify articles comparing
outcome data from different surgical techniques for SBC removal (syntax
provided in Appendix 1). No restriction regarding publication data and
language were applied. This study is reported according to the Preferred
Reporting Items for Systematic Review and Meta-analysis (PRISMA)
statement (14).

\textbf{Study selection}Two authors (S.M., R.M.) independently screened
the retrieved articles on title and abstract using pre-defined inclusion
and exclusion criteria (Fig. 1). The selected articles were read in
full-text by the aforementioned two authors. Only studies comparing
different surgical techniques in one cohort of patients were selected.
The reference lists of the selected articles were reviewed for a
cross-reference check to select relevant studies that were not
identified in the initial search. All authors were involved in the
discussion leading to final article inclusion. Disagreement between
authors was solved by discussion.

\textbf{Data extraction}Data from all included studies was independently
extracted by the authors. The predefined included data contained: year
of publication, number of included patients (total and patients with SBC
specifically), occurrence of bilateral anomalies, pre-operative SBC
infection, gender, age at surgery, pre-operative imaging with: computed
tomography, magnetic resonance imaging or ultrasound, operation
technique, operating time, incision type and length, follow up duration,
recurrence and complication rates, and scar satisfaction.

\textbf{Quality assessment} Four authors (S.M., H.B., E.v.d.V. and
M.v.d.A.) critically appraised selected articles regarding directness of
evidence (DoE) and risk of bias (RoB) (Table 1). We assessed the DoE
using three criteria: 1) domain: studies comparing surgical techniques
for SBC removal 2) determinant: clear description of the selected
surgical technique and 3) surgical outcome: report on recurrence and
complication rates. To perform RoB assessment on the selected studies,
authors applied an appraisal tool derived from the Cochrane risk of bias
Tool (15) . Each criterion was rated satisfactory (*), partly
satisfactory (*), or unsatisfactory (-) (explanatory legend of Table 1).
Overall DoE was rated as high (H), moderate (M) or low (L). Only studies
with a high directness of evidence were selected for final inclusion. No
studies were excluded based on RoB, adhering to the Grading of
Recommendations Assessment, Development and Evaluation (GRADE) system
(16).

\textbf{Data synthesis} Pooling of data was considered in case of
homogeneity between studies (if I\textsuperscript{2} was
\textless{}50\%)(17).

\textbf{RESULTS} An overview of the study selection process and reasons
for exclusion is presented in figure 1. (flowchart). Four articles had a
high DoE and were included for final selection. This resulted in the
inclusion of the treatment of 140 cysts. No patients with bilateral
cysts were included. These four studies (6,9,10,12) contained two
randomized controlled trails (RCTs) and two prospective trials. For an
overview of the included surgical techniques see Figure 2 and the
description in Appendix 2. Two authors (9,10) were contacted to provide
additional information regarding the applied incision type, however, no
additional information was provided. The inclusion dates of the patient
cohorts of Chen \emph{et al.} 2012 (10) and Chen \emph{et al.} 2014 (9)
did not overlap and therefore, both studies were included in the current
review. Meta-analysis was not performed in this review due to
heterogeneity regarding: baseline characteristics, study design and
applied surgical techniques.

\textbf{Data extraction: \emph{}} Table 2 shows the data extraction of
four included studies that directly compared outcomes between
conventional surgery and modern removal techniques in patients
presenting with unilateral SBCs. All patients from these studies
underwent pre-operative imaging using CT-scan or ultrasound scanning and
pre-operative fine needle cytology to confirm the diagnosis (data not
shown). Chen \emph{et al.} (10) compared SBC removal results between
conventional, curvilinear, cervical incisions along a natural skin
crease (3-4 cm below the lower border of the mandible) to the endoscopic
RAHI technique. Adult patients were randomly assigned between both
techniques (Table 2). None of the included patients suffered from a
pre-operative SBC infection. No recurrence occurred during a follow up
of at least six months. There was no significant difference in operating
time between both techniques; however, there was a significantly
(\emph{p} = \textless{} .001) higher scar satisfaction rate in the RAHI
group. Scar satisfaction was measured six months postoperatively using a
visual analog scale ranging from 0-10. Chen \emph{et al.} (9) compared
SBC removal using a curvilinear cervical incision along a natural skin
crease (4-5 cm below the lower border of the mandible) to an endoscopic
approach of the lateral neck using two randomly assigned patient groups.
Twenty adult patients were assigned to the conventional cervical
incision, whereas 21 patients were assigned to the endoscopic lateral
neck approach. None of the included patients suffered from a
pre-operative SBC infection. No recurrence occurred during a follow up
of at least six months. Although no significant difference in operating
time was reported between both groups, incision length and scar
satisfaction did significantly (\emph{p} \textless{} .05) differ in
favor of the endoscopic technique. Scar satisfaction was measured six
months postoperatively using a visual analog scale ranging from 0-10.
Ahn \emph{et al} . (12) compared SBC removal outcomes between a
conventional approach (by making a curvilinear incision directly over
the anomaly) and an open RAHI approach in a prospective case control
study. Thirteen adult patients were operated by the open RAHI approach
while 17 adult patients underwent a (conventional) cervical incision.
Ahn \emph{et al.} reported a pre-operative SBC infection rate of 30.8\%
in the patients who were operated using the open RAHI technique. No
recurrence occurred during a follow up of three months. Of the patients
who underwent conventional surgery, 11.8\% suffered from a postoperative
hematoma or seroma, compared to 7.7\% of the patients who underwent open
RAHI surgery (\emph{non-significant difference} ). Only patients of the
open RAHI group suffered from postoperative neurological damage that
spontaneously resolved (23.1\%). The retro-auricular approach entailed
significantly longer operating time (\emph{p} = .019), however, resulted
in significantly higher scar satisfaction (\emph{p=} \textless{} .001).
Scar satisfaction was measured three months postoperatively using a
visual analog scale ranging from 0-10. Iaremenko \emph{et al.} (6)
compared SBC removal outcomes between a conventional approach (by making
a skin incision 2.0-2.5 centimeter below the lower border of the
mandible) and an endoscopic occipital approach using a controlled study
design. The latter technique is comparable to the endoscopic RAHI
technique of Chen \emph{et al.} (10) from a surgical perspective.
Twenty-two adult patients were operated by the occipital endoscopic
approach, while 22 adult patients underwent a (conventional) cervical
incision. No recurrence occurred during a follow up of six months. Of
the conventional group, 4.5\% developed a hematoma and 4.5\% developed
temporary neurological damage. In the occipital approach group 27.3\%
reported temporary pain and difficulty at sideward arm raise. The
endoscopic approach resulted in a significantly higher scar satisfaction
(\emph{p =} .05), but took significantly longer operating time (\emph{p
=} .05). Scar satisfaction was measured six months postoperatively using
the criteria `emotional component' of the `Attitude to health'
questionnaire. Since no recurrence was reported in any of the included
studies, no data regarding revision surgery were retrieved.

DISCUSSION Summary of findings: In this systematic literature review, we
compared the clinical outcome (complication and recurrence rates and
scar satisfaction) of SBC removal between conventional surgery and less
invasive removal techniques (endoscopic surgery or open/endoscopic
RAHI). Only four studies (6,9,10,12) were identified that compared the
conventional technique with newer techniques within one patient cohort.
All of these included studies are of low quality due to: short follow up
periods, small patient groups and a study design prone to bias due to
both selection criteria (e.g. no inclusion of pre-operatively infected
cysts) and lack of blinding. Since evidence is scarce, it remains
difficult to provide evidence-based surgical treatment advice. Results
demonstrate that surgical treatment of SBC results in a complication
rate ranging between 0 to 27.3\%. The most reported complications were
temporary earlobe hypoesthesia in patients who underwent endoscopic or
(endoscopic) RAHI surgery (most likely due to perioperative greater
auricular nerve manipulation), temporary pain and difficulty of sideward
arm raise (most likely resulting from spinal accessory nerve
manipulation). No permanent neurological damage was reported. Surgical
treatment provides a definitive treatment with no reported recurrence
using either one of the techniques. Studies that compared both
techniques within the same adult patient cohort demonstrated that both
the (endoscopic) RAHI approach as well as other endoscopic techniques
resulted in higher scar satisfaction. Therefore, available evidence
demonstrates that application of less invasive SBC removal techniques to
treat uninfected second branchial cleft cysts results in relatively
higher, temporary complication rates, however, with a significantly
higher scar satisfaction. An interesting result, since the operating
area is in a prominently visible location in a patient population
containing young adults.

Two included studies (9,10) excluded patients presenting with fistulas
and sinuses, pre-operatively infected SBCs and patients who underwent
prior neck surgery or radiotherapy. Only Ahn \emph{et al.} reported on
open RAHI treatment of patients with pre-operatively infected SBCs.
Although 30.8\% of these patients suffered from a pre-operative
infection, no relatively higher complication rate was reported for this
population compared to the cervical incision group. Iaremenko \emph{et
al.} did not report whether any pre-operatively infected SBC were
included in their study cohort.

Comparison with other studies and techniques: This is the first
literature review reporting on the clinical outcome of SBC removal
comparing different surgical techniques. Cohort studies(9,11,13)
investigating either open RAHI or endoscopic RAHI found similar results:
absence of recurrence in combination with low complication rates, with
an average follow up of (at least) 6, 14.5 and 42 months respectively.
The only reported complications in open RAHI surgery were temporary
hypoesthesia of the earlobe and hypertrophic scars.

In previous studies, conventional second branchial arch anomaly removal
techniques have been studied intensively. Appendix 3 shows an overview
of these studies that were identified through the same literature
search. This Appendix also includes patients presenting with fistulas
and sinuses (mostly children). Precise data regarding the distribution
of (included) cysts, sinuses and fistulas, side of the anomalies,
description of the used surgical technique or duration of follow up is
lacking in most studies (Appendix 3). Only retrospective studies were
identified with a complication rate ranging between 0 and 32\% and a
recurrence rate ranging between 0 and 4.9\%. These recurrence rates were
reported when follow up lasted till four or even ten years (18,19).
Therefore, the follow-up of the included studies in this review (ranging
between 3-24 months) could be too short to identify recurrence following
surgery. Long-term recurrence rates are of major importance because
recurrence of disease will cause high morbidity and can make revision
surgery complex. Furthermore, this short follow up could also affect the
reported scar satisfaction since three to six months after surgery the
final scar result may not be visible yet.

Multiple authors (20--22) refer to Deane \emph{et al.} (23) regarding
recurrence percentages: Deane \emph{et al} described the results of a
retrospective study (performed between 1954 and 1975) including 274
patients with branchial cleft remnants below the mandible. The surgical
technique is described as a local excision of the lesion (plus tract
when necessary). The reported recurrence rate was 2.7\% in patients
without a prior infection, 14\% in patients with a pre-operative
infection and 21.2\% in patients who underwent revision surgery. The
average follow up duration was 12.4 years (1-22 years). No distinction
between second, third and fourth branchial anomalies was made.

Quality of evidence and potential biases The overall quality of the
included studies was low (IIb -IV regarding the \emph{Oxford Centre for
Evidence-Based Medicine guidelines} ): only two studies used a RCT to
compare the clinical outcome between surgical techniques. In these RCTs,
selection bias could not be ruled out since lack of blinding. The
quality of evidence regarding SBAA removal was mostly affected by small
patient cohorts resulting in Type II error (i.e., failing to reject a
false null hypothesis), short follow up, unclear inclusion criteria and
selective reporting.

\textbf{Conclusion}

This literature review compares the clinical outcome of SBC removal
between conventional surgery and endoscopic surgery or open/endoscopic
RAHI. Surgical treatment of uninfected SBCs provides a definitive
solution with no reported recurrence using either one of the techniques
during relatively short follow up (range: {[}3 to 24 months{]}).
Endoscopic or (endoscopic) RAHI surgery results in significantly higher
scar satisfaction in comparison with the conventional technique in
adults, however, causes more temporary complications (0 -- 27.3\%).
Since follow up was short, recurrence rates could be underreported and
scar satisfaction could be affected by not (yet) judging the final scar
result. Large prospective studies with long-term follow up
(\textgreater{} five years) are currently lacking and will be essential
to confirm whether newer techniques (endoscopic surgery or
open/endoscopic RAHI) indeed result in higher scar satisfaction and less
recurrence on the long-term.

REFERENCES

1. Acierno SP, Waldhausen JHT. Congenital cervical cysts, sinuses and
fistulae. Otolaryngol Clin North Am. 2007 Feb;40(1):161--76, vii--viii.

2. Adams A, Mankad K, Offiah C, Childs L. Branchial cleft anomalies: a
pictorial review of embryological development and spectrum of imaging
findings. Insights Imaging. 2016 Feb;7(1):69--76.

3. Piccin O, Cavicchi O, Caliceti U. Branchial cyst of the
parapharyngeal space: report of a case and surgical approach
considerations. Oral Maxillofac Surg. 2008 Dec;12(4):215--7.

4. Gourin CG, Johnson JT. Incidence of unsuspected metastases in lateral
cervical cysts. Laryngoscope. 2000 Oct;110(10 Pt 1):1637--41.

5. Sira J, Makura ZGG. Differential diagnosis of cystic neck lesions.
Ann Otol Rhinol Laryngol. 2011 Jun;120(6):409--13.

6. Iaremenko AI, Kolegova TE, Sharova OL. Endoscopically-Associated
Hairline Approach to Excision of Second Branchial Cleft Cysts. Indian J
Otolaryngol head neck Surg Off Publ Assoc Otolaryngol India. 2019
Oct;71(Suppl 1):618--27.

7. Mitroi M, Dumitrescu D, Simionescu C, Popescu C, Mogoant\selectlanguage{romanian}ǎ C,
Cioroianu L, et al. Management of second branchial cleft anomalies. Rom
J Morphol Embryol. 2008;49(1):69--74.

8. Teng SE, Paul BC, Brumm JD, Fritz M, Fang Y, Myssiorek D.
Endoscope-assisted approach to excision of branchial cleft cysts.
Laryngoscope. 2016;126(6):1339--42.

9. Chen J, Chen W, Zhang J, He F, Zhu Z, Tang S, et al.
Endoscope-assisted second branchial cleft cyst resection via an incision
along skin line on lateral neck. Eur Arch Otorhinolaryngol. 2014
Oct;271(10):2789--93.

10. Chen LS, Sun W, Wu PN, Zhang SY, Xu MM, Luo XN, et al.
Endoscope-assisted versus conventional second branchial cleft cyst
resection. Surg Endosc Other Interv Tech. 2012;26(5):1397--402.

11. Chen W-L, Fang S-L. Removal of second branchial cleft cysts using a
retroauricular approach. Head Neck. 2009 May;31(5):695--8.

12. Ahn D, Lee GJ, Sohn JH. Comparison of the Retroauricular Approach
and Transcervical Approach for Excision of a Second Brachial Cleft Cyst.
J Oral Maxillofac Surg. 2017 Jun;75(6):1209--15.

13. Roh JL, Yoon YH. Removal of pediatric branchial cleft cyst using a
retroauricular hairline incision (RAHI) approach. Int J Pediatr
Otorhinolaryngol. 2008;72(10):1503--7.

14. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting
items for systematic reviews and meta-analyses: the PRISMA statement.
PLoS Med. 2009 Jul;6(7):e1000097.

15. Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et
al. The Cochrane Collaboration's tool for assessing risk of bias in
randomised trials. BMJ. 2011 Oct;343:d5928.

16. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et
al. Grading quality of evidence and strength of recommendations. BMJ.
2004 Jun;328(7454):1490.

17. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring
inconsistency in meta-analyses. BMJ. 2003 Sep;327(7414):557--60.

18. Spinelli C, Rossi L, Strambi S, Piscioneri J, Natale G, Bertocchini
A, et al. Branchial cleft and pouch anomalies in childhood: A report of
50 surgical cases. J Endocrinol Invest. 2016;39(5):529--35.

19. Perez JA, Henning E, Valencia V, Schultz C. {[}Cysts of second
branchial cleft: review of 32 operated cases{]}. Rev Med Chil. 1994
Jul;122(7):782--7.

20. Choi SS, Zalzal GH. Branchial anomalies: a review of 52 cases.
Laryngoscope. 1995 Sep;105(9 Pt 1):909--13.

21. Li W, Xu H, Zhao L, Li X. Branchial anomalies in children: A report
of 105 surgical cases. Int J Pediatr Otorhinolaryngol. 2018
Jan;104:14--8.

22. Kajosaari L, M\selectlanguage{ngerman}äkitie A, Salminen P, Klockars T. Second branchial
cleft fistulae: Patient characteristics and surgical outcome. Int J
Pediatr Otorhinolaryngol. 2014;78(9):1503--7.

23. Deane SA, Telander RL. Surgery for thyroglossal duct and branchial
cleft anomalies. Am J Surg. 1978 Sep;136(3):348--53.

Appendix 1: Search syntax:

Pubmed:

1. (((second{[}Title/Abstract{]}) OR 2nd{[}Title/Abstract{]})
2.(((pharyng*{[}Title/Abstract{]}) OR branch*{[}Title/Abstract{]}) OR
viscer*{[}Title/Abstract{]}) OR branchial region{[}MeSH Major Topic{]}
3.((((cleft*{[}Title/Abstract{]}) OR groov*{[}Title/Abstract{]}) OR
pouch*{[}Title/Abstract{]}) OR regio*{[}Title/Abstract{]}) OR
arch*{[}Title/Abstract{]} 4.(((((((((((((anomal*{[}Title/Abstract{]}) OR
malform*{[}Title/Abstract{]}) OR defec*{[}Title/Abstract{]}) OR
deform*{[}Title/Abstract{]}) OR cyst*{[}Title/Abstract{]}) OR
tract*{[}Title/Abstract{]}) OR fistu*{[}Title/Abstract{]}) OR
pit*{[}Title/Abstract{]}) OR pouch*{[}Title/Abstract{]}) OR
leas*{[}Title/Abstract{]}) OR lesi*{[}Title/Abstract{]}) OR
mass*{[}Title/Abstract{]}) OR sinus*{[}Title/Abstract{]}) OR congenital
abnormalities{[}MeSH Major Topic{]}

5.((((((((treat*{[}Title/Abstract{]}) OR procedur*{[}Title/Abstract{]})
OR oper*{[}Title/Abstract{]}) OR surg*{[}Title/Abstract{]}) OR
therap*{[}Title/Abstract{]}) OR excis*{[}Title/Abstract{]}) OR
manag*{[}Title/Abstract{]}) OR surgical procedures, Operative{[}MeSH
Major Topic{]}) OR Surgery{[}MeSH Subheading{]} 1 AND 2 AND 3 AND 4 AND
5

Embase:

1.second*:ab,ti OR 2nd:ab,ti 2. pharyng*:ab,ti OR branch*:ab,ti OR
viscer*:ab,ti OR 'branchial arch'/exp ~ 3. cleft*:ab,ti OR groov*:ab,ti
OR pouch*:ab,ti OR regio*:ab,ti OR arch*:ab,ti 4. anomal*:ab,ti OR
malform*:ab,ti OR defec*:ab,ti OR deform*:ab,ti OR cyst*:ab,ti OR
tract*:ab,ti OR fistu*:ab,ti OR pit*:ab,ti OR leas*:ab,ti OR lesi*:ab,ti
OR mass*:ab,ti OR sinus*:ab,ti OR 'congenital disorder'/exp 5.
treat*:ab,ti OR procedur*:ab,ti OR oper*:ab,ti OR surg*:ab,ti OR
therap*:ab,ti OR excis*:ab,ti OR manag*:ab,ti OR 'surgery'/exp

1 AND 2 AND 3 AND 4 AND 5

Cochrane:

\begin{enumerate}
\tightlist
\item
  Second or 2nd:ti,ab,kw
\item
  Pharyng* or branch* or viscer*:ti,ab,kw (Word variations have been
  searched)
\item
  Cleft* or groov* or pouch* or Regio* or arch*:ti,ab,kw (word
  variations have been searched)
\item
  Anomal* or malform* or defec* or deform* or cyst* or tract* or fistu*
  or pit* or pouch* or leas* or lesi* or mass* or sinus*: ti,ab,kw (word
  variations have been searched)
\item
  Treat* or procedur* or oper* or surg* or therap* or excis* or
  manag*:ti,ab,kw (Word variations have been searched)
\end{enumerate}

1 AND 2 AND 3 AND 4 AND 5

Table 1: Critical Appraisal of Topic\selectlanguage{english}
\begin{longtable}[]{@{}lllllllllllllll@{}}
\toprule
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Study (et al), year\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Study design\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Sample size(n)\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Sample size(n)\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
domain\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
determinant\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
out- come\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
DoE total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
DoE total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Patient selection\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Allocation concealment\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Blinding\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Incomplete outcome\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Follow up\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Selective reporting\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L. Chen, 2012\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCT\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
25\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
25\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
J. Chen, 2014\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCT\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
41\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
41\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Ahn, 2017\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
PT\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
30\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
30\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Iaremenko 2018\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
PT\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
44\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
44\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Legend: NA= not applicable. PT= prospective trial. RCT = randomized
controlled trail RCS = retrospective case study. Symbols: satisfactory
(*), partly satisfactory (*), or unsatisfactory (-). Inclusion: high
Directness of Evidence.

Explanatory Legend of table 1: Critical appraisal of studies reporting
on surgical treatment of 2\textsuperscript{nd} branchial arch cysts

Assessed Study Aspect:

\textbf{DIRECTNESS OF EVIDENCE:}Domain: -2\textsuperscript{nd} branchial
cyst only or 2\textsuperscript{nd} branchial cysts reported separately -
also other branchial arch anomalies included -

Determinant: - clear description of surgical technique - unclear
description of surgical technique * - no description of surgical
technique -

Outcome: - recurrence rate clearly mentioned - no recurrence rate
mentioned -

\textbf{RISK OF BIAS:}1.Patient selection: - Clear inclusion and
exclusion criteria - Unclear inclusion and exclusion criteria -

2. Allocation concealment: - type of treatment is randomly assigned -
treatment is not randomly assigned - - Not applicable NA

3. Blinding: - the two treatment groups were blinded for the researchers
- the two treatment groups were not blinded for the researchers - - Not
applicable NA

4. Incomplete outcome: - \textless{}10\% loss to follow up -
\textgreater{}10\% loss to follow up or unclear -

5. Follow up: - \textgreater{} 1 year - \textgreater{} 6 months * -
unclear -

6. Selective reporting: - clear definition and description of
complications - unclear or no definition and description of
complications -

DIRECTNESS OF EVIDENCE: = 1 point * = 0,5 point - = 0 points RISK OF
BIAS: - = 1 point * = 0,5 point = 0 points

Table 2: Results of the included studies selected from the systematic
review.\selectlanguage{english}
\begin{longtable}[]{@{}lllllllll@{}}
\toprule
Study & Chen, 2012 (10) & Chen, 2012 (10) & Chen, 2014 (9) & Chen, 2014
(9) & Ahn, 2017 (12) & Ahn, 2017 (12) & Iaremenko, 2018 (6) & Iaremenko,
2018 (6)\tabularnewline
\midrule
\endhead
Incision type & Cervical incision & Endoscopic RAHI & Cervical incision
& Endoscopic lateral neck incision & Cervical incision & Open RAHI &
Cervical incision & Endoscopic occipital incision\tabularnewline
Patients & 12 & 13 & 20 & 21 & 17 & 13 & 22 & 22\tabularnewline
Sex (male/female) & 5/7 & 6/7 & 9/11 & 8/13 & 9/8 & 2/11 & 5/17 &
7/15\tabularnewline
Age (years) & 31.7 (median\selectlanguage{ngerman}±2.9) & 26.0 (median\selectlanguage{ngerman}±11.9) & 32 (median\selectlanguage{ngerman}±11) &
29 (median \selectlanguage{ngerman}± 8) & 34.3 {[}range 19-64{]} & 30.5 {[}range 17-47{]} & 30.4
\selectlanguage{ngerman}± 11.4 & 31.6 \selectlanguage{ngerman}±10.8\tabularnewline
Follow up (months) & median 16 (6-24) & median 16(6-24) & 16 (6-24) & 16
(6-24) & 3 & 3 & 6 & 6\tabularnewline
Scar satisfaction: & 6.2 \selectlanguage{ngerman}± 0.8* & 9.2 \selectlanguage{ngerman}± 0.6* & 6.4 \selectlanguage{ngerman}± 0.5* & 8.0 \selectlanguage{ngerman}± 0.8 *
& 6.2 (4-8)** & 8.8 (7-10)** & 79.1 \selectlanguage{ngerman}±12.0 *** & 97.6\selectlanguage{ngerman}± 18.5
***\tabularnewline
Incision length (in centimeters) & NR & NR & 6.4 \selectlanguage{ngerman}± 0.5 & 2.7 \selectlanguage{ngerman}± 0.3 & NR
& NR & 5.1 \selectlanguage{ngerman}± 0.9 & 5.5 \selectlanguage{ngerman}± 0.6\tabularnewline
Operating time (in minutes) & 49.6 \selectlanguage{ngerman}± 6.9 & 54.6 \selectlanguage{ngerman}± 6.3 & 94 \selectlanguage{ngerman}± 21 & 83 \selectlanguage{ngerman}±
18 & Mean 68 (45-90) & Mean 84 (60-140) & 85 \selectlanguage{ngerman}±15 & 65 \selectlanguage{ngerman}±13\tabularnewline
Complications: & Complications: & Complications: & Complications: &
Complications: & Complications: & Complications: & Complications: &
Complications:\tabularnewline
\textbf{Recurrence:} & \textbf{0\%} & \textbf{0\%} & \textbf{0\%} &
\textbf{0\%} & \textbf{0\%} & \textbf{0\%} & \textbf{0\%} &
\textbf{0\%}\tabularnewline
Seroma / hematoma & 0\% & 0\% & 0\% & 0\% & 11.8\% & 7.7\% & 4.5\% &
0\%\tabularnewline
Infection & 0\% & 0\% & 0\% & 0\% & 0\% & 0\% & 0\% & 0\%\tabularnewline
Temporary hypoesthesia of the earlobe & 0\% & 7.7\% & 0\% & 0\% & 0\% &
23.1\% & NR & NR\tabularnewline
Temporary pain and difficulty at sideward raising of the arm & NR & NR &
NR & NR & NR & NR & 4.5\% & 27.3\%\tabularnewline
\bottomrule
\end{longtable}

Abbreviations: RAHI= Retro Auricular hairline incision NR= not reported

*Scar satisfaction was measured using a visual analog scale ranging from
0-10 six months after surgery **Scar satisfaction was measured using a
visual analog scale ranging from 0-10 three months after surgery ***
Scar satisfaction was measured using the questionnaire ``Attitude to
health'' by R.A. Berezovskaya. Six months after surgery. The criteria
``emotional component'' was selected for evaluation of subjective
satisfaction with incision scar.

Figure 1: Flow-chart demonstrating the selection of articles from the
literature describing surgical second branchial cyst removal.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image1/image1}

\end{center}
\end{figure}

Figure 2: overview of used surgical techniques.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image2/image2}

\end{center}
\end{figure}

Appendix 2: overview of surgical techniques.

\emph{Conventional approach:} \emph{(Iaremenko (6)):} An incision is
made in the upper third part of the lateral neck, along a skin crease.
Usally 2,0-2.5 below the lower border of the mandibule. Incision is made
trough the subcutaneous tissue, the fascia superficialis, platysma
muscle. External jugular vein is transected and ligated. Fascia media
and fascia profunda are dissected. Cyst fluid aspiration is performed if
required. Cyst is removed in total. The wound is closed layer by layer
using biodegradable sutures. Drainage tube is placed. The wound is
covered with a tight aseptic dressing.

\emph{Retro auricular hairline approach (Chen 2009 (11)):} Retro
auricular incision was made through the skin, subcutaneous tissue, and
platysma

muscle. The incision was made along the post auricular sulcus and
hairline, starting from the lower end of the post auricular sulcus,
moving upward to the middle or upper third of the sulcus, and then
smoothly angulating downward to 0.5 to 1 cm under the hairline. Careful
attention to the overlying sternocleidomastoid muscle prevented injury
to the great auricular nerve. The skin flap

was elevated just above the sternocleidomastoid muscle onto the carotid
triangle. The cysts were exposed anterior and deep to the
sternocleidomastoid muscle at the level of the carotid bifurcation. Dull
dissection was used to free the attachments of the cysts. The cysts were
then completely removed after aspirating luminal contents. All of the
cysts were separated easily from the surrounding

normal tissues and removed completely using this approach without tumor
spillage. The retro auricular skin flap was repositioned and sutured.

\emph{Endoscopic lateral neck approach} \emph{(Chen 2014(9)):} A lateral
neck incision was made in the skin, subcutaneous tissue, and platysma
muscle. The incision was made along the skin line below the lower bound
of the cyst. The working space was created by elevating the skin flap
with self-designed custom-made retractors to establish a stable
operative space. The wound margin was protected by two applications to
avoid injury from the ultrasonic scalpel. Dissection using the
ultrasonic scalpel was performed to free the attachments of the cyst.
When we separated the cyst, we took care to avoid impairing the common
carotid artery, internal jugular vein, vagus nerve, hypoglossal nerve,
and accessory nerve. The cyst was completely removed. For very large
cysts (longest diameter

of 7 cm) decompression was often performed by fluid aspiration and
needle pricking.. The wound was closed by a subcuticular suture with 4-0
Dexon, and a small ventricular drainage tube was inserted.

\emph{Endoscopic RAHI: (Chen 2012 (10)):} A retroauricular incision was
made through the skin, subcutaneous tissue, and platysma muscle. The
incision was made along the postauricular sulcus and hairline, starting
from the lower end of the postauricular sulcus, moving upward to the
middle or upper third of the sulcus, and then smoothly angulating
downward to 0.5 cm above

the hairline. The skin flap was dissected under platysma with the help
of the 4-mm-diameter endoscope. During this step, careful attention to
the overlying sternocleidomastoid muscle prevented injury to the great
auricular nerve and external jugular vein. The working space was then
produced by elevating the skin flap just above the sternocleidomastoid
muscle onto the carotid triangle. The cyst was exposed anterior and deep
to the sternocleidomastoid muscle at the level of the carotid
bifurcation after carful dissection of the accessory nerve and posterior
belly of digastric muscle. Then, dissection using the ultrasonic scalpel
was carried out to free the attachments of the cyst, and the cyst was
completely removed. In very large cysts (longest diameter 8 cm),
decompression was often performed by fluid aspiration and
needle-pricking. Finally, the wound was closed by subcuticular suture
with 4-0 Dexon, and a small Hemovac was placed for drainage.

\emph{Occipital endoscopic approach: (Iaremenko (6))}

An incision was performed in the occipital hairline region from
occipital bone condylar fossa and going along the hairline 1.2 \selectlanguage{ngerman}± 0.3 cm
under it. Layer by layer incision of skin and subcutaneous tissue was
done. Fascia dissection was performed by means of unipolar and bipolar
laparoscopic tools; a ``tunnel'' was formed under control of a rigid
endoscope; ``tunnel'' vector was directed along the inferior border of
the mandible. Anterior border of sternocleidomastoid muscle was
visualized; fascia dissection under internal border of
sternocleidomastoid muscle was performed, and the muscle was elevated by
means of a retractor. Neurovascular bundle fascia was dissected and
exposed the cyst fascia with an anterior-inferior adjoining swollen
lymphatic node. In larger cysts, the cyst fascia exposed under the
internal border of sternocleidomastoid muscle. In all the cases,
aspiration of cyst fluid was performed. The fascia was clamped with
forceps and excised by means of ultrasound unipolar and bipolar
laparoscopic tools. Tube drainage was inserted into the wound on vacuum.
The wound was closed layer by layer with biodegradable synthetic loop
sutures. The skin incision was closed with polypropylene loop sutures.
The wound was covered with tight aseptic dressing.

\textbf{Appendix 3} : Studies using conventional surgery for removal of
second branchial arch anomalies (including cysts, fistulas and sinus).\selectlanguage{english}
\begin{longtable}[]{@{}llllllllll@{}}
\toprule
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Study (et al), year (reference)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Study design\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Used surgical technique\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Patients with 2nd arch anomaly (total)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Cyst-fistula-sinus total\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Side (L-R-B) / Sex (M-F)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Age at surgery (in years) (SD or range)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Follow-up (in months)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Recurrence\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Complications\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Queizan, 1985}(1)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Fistula: elliptical incision Cyst: cervical, transversal incision\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
48 (52)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
11-19-13(17 remnants)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
B: 7/ (27-25)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1-7y\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Doi, 1988} (2)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
`surgical excision'\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
44 (58)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
7-20-12-39\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR / (32-26)*\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Fistula \textless{}5 cyst \textgreater{}9\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2.3\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Ford, 1992} (3)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
68/98 conventional 30/98 stepladder\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
98 (106)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
90-2-?-98 **\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
40\%-60\%-6 / (45-53)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\textless{}13y\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\textbf{Perez, 1994}(4)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
`cystectomy'\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
19 (32)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
19-0-0-19\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR /(11-21)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
23.9\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
4 years\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
6.3\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9.4\% wound infection\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Atlan, 1997} (5)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
`Local excision'\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
17 (20)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR / (11-6)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2-60m\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11.8\% hypertrofic scar\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\textbf{Agaton, 1996}(6)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wide, transverse cervicotomy\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
137(183)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
113-24-0-137\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
(58-123-2) / (43-98)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Cyst mean 23,6 fistula mean 24,6\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
24\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
4.9\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2.9\% temporary neurological damage 6.6\% infection 11.7\%
hematoma/seroma\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Karabulut, 2005} (7)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stepladder incision\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
14 (14)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
?-?-13-14\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
(6-R-3)/ (6---8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
1,5-16 (5.3)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
6 years\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Rattan, 2006} (8)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
32/52 surgical excision 20/52 surgical excision and fistulogram 10/52
stepladder\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
52 (52)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0-52-0-52\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
(12-29-11)/ (38-14)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1-13 (4.5)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
4\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
32\% methylene spill\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Schroeder, 2007}(9)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Lateral cervicotomy\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
51 (67)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
14-14-23- 51\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NA/NA\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Cyst: 4.9[?] Sinus: 4.5[?] fistula: 2.8[?]\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
48\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3.9\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1.9\% temporary neurological damage 1.5\% hematoma/seroma 10.4\%
infection\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\textbf{Mitroi, 2008} (10)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Lateral cervicotomy\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
23(23)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
10-0-13-23\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR / (11-12)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
1-5 years\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\textbf{Papadogeorgakis, 2009} (11)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Lateral cervicotomy\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
18(18)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
18-0-0-18\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11-7 / (10-8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
27.8 (21-62)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
1-7y\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11.1\% seroma\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Bajaj, 2011}(12)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
55/62 elliptical incision 7/62 stepladder\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
62 (80)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
16-34-12 / (30-32)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1-14\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
6 weeks\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1.6\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1.6\% seroma\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Maddalozzo, 2012}(13)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Elliptical incision (4cm)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
208(232)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
?-28-?-232\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0-25-3 / (11-17)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
6-131 months\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2 years\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Zeifullah, 2012} (14)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Wide horizontal incision / stepladder\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11 (26)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11-2-0-13***\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
7-3-1 / (5-7)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
19,6 (4-44)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
25\% hypertrofic scar\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Erikci, 2014} (15)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
`surgical resection'\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
24(179)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
8-16-0-24\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11/10/4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0-14\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
4-120m\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Kajosaari, 2014} (16)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
`surgical excision'\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
68(68)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0-68-0-68\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
(13-49-6) / (39-29)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0-16\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2.9\% tonsillectomy re-bleed 1.5\% disturbing scar\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\textbf{Prasad, 2014} (17)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
`surgical excision'\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
17 (34)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
8-9-0-17\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR / (9-8)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
5.9\% wound infection 5.9\% wound gaping 5.9\% neurological
deficit\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\emph{Spinnelli, 2015} (18)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Transverse cervical incision\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
39(50)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
11-27-1-39\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR / (21-29)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Cyst 9.5 Fistula 5.1 Sinus 3.7\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1-10 years\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
4\%\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\emph{Kalra, 2017} (19)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
`surgical excision'\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
94 (94)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
8-48-38-94\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
(24-62-8)/(70-24)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
3m-14y\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2.1\%\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
4.2\% wound infection\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Adult studies marked in \textbf{bold} , pediatric studies
in\emph{italic} . Abbreviations: NR = not reported L = left R = Right B
= Bilateral M = male F = Female Symbols: \textasciitilde{} RCS =
retrospective cohort study *all patients (also including other than
2\textsuperscript{nd} branchial anomalies) ** 90 patients had cleft
sinus or cyst, 6 had cleft cartilage remnant. ***= (1 cyst and fistela
bilateral) [?]= average  in only 19/32 patients the perioperative
diagnosis of 2nd branchial cyst was made. Recurrence and complications
were calculated for 32 patients.

Critical Appraisal of Topic of studies in Appendix 3\selectlanguage{english}
\begin{longtable}[]{@{}lllllllllllllll@{}}
\toprule
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Directness of evidence\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Risk of Bias\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Study (et al), year\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Study design\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Sample size(n)\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Sample size(n)\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
domain\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
determinant\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
out- come\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
DoE total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
DoE total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Patient selection\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Allocation concealment\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Blinding\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Incomplete outcome\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Follow up\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Selective reporting\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Schroeder, 2007\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
51\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
51\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
H\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Queizan, 1985\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
48\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
48\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Ford, 1992\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
98\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
98\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Perez , 1994\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
32\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
32\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Karabulut, 2005\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
14\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
14\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Mitroi et al, 2008\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
23\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
23\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Roh, 2008\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
PT\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
W. Chen, 2009\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
8\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
8\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Papadogeorgakis, 2009\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
18\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
18\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Bajaj, 2011\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
62\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
62\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Maddalozzo 2012\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
28\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
28\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Erikci, 2014\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
24\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
24\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Prasad, 2014\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
17\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
17\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Spinelli, 2016\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
39\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
39\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Teng, 2016\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
25\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
25\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{NA}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Kalra, 2017\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
94\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
94\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
M\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Doi, 1988\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
44\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
44\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Choi, 1995\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
21\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
21\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Agaton, 1996\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
137\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
137\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Atlan , 1997\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
17\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
17\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Rattan, 2006\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
52\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
52\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Al-Khateeb, 2007\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
47\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
47\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Zaifullah, 2013\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
11\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
11\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Al-Mufarrej, 2017\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
316\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
316\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
Li, 2018\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
RCS\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
13\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
13\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{-}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
L\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
NA\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\textbf{*}\strut
\end{minipage} & \begin{minipage}[t]{0.04\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Legend: NA= not applicable. PT= prospective trial. RCT = randomized
controlled trail RCS = retrospective case study. Symbols: satisfactory
(*), partly satisfactory (*), or unsatisfactory (-). Inclusion: high
Directness of Evidence.

REFERENCES APPENDIX 3

1. Queizan A, Martinez Urrutia MJ. {[}Branchial cysts and fistulas{]}.
An Esp Pediatr. 1985 Jun;22(8):596--600.

2. Doi O, Hutson JM, Myers NA, McKelvie PA. Branchial remnants: a review
of 58 cases. J Pediatr Surg. 1988 Sep;23(9):789--92.

3. Ford GR, Balakrishnan A, Evans JN, Bailey CM. Branchial cleft and
pouch anomalies. J Laryngol Otol. 1992 Feb;106(2):137--43.

4. Perez JA, Henning E, Valencia V, Schultz C. {[}Cysts of second
branchial cleft: review of 32 operated cases{]}. Rev Med Chil. 1994
Jul;122(7):782--7.

5. Atlan G, Egerszegi EP, Brochu P, Caouette-Laberge L, Bortoluzzi P.
Cervical chrondrocutaneous branchial remnants. Plast Reconstr Surg. 1997
Jul;100(1):32--9.

6. Agaton-Bonilla FC, Gay-Escoda C. Diagnosis and treatment of branchial
cleft cysts and fistulae. A retrospective study of 183 patients. Int J
Oral Maxillofac Surg. 1996;25(6):449--52.

7. Karabulut R, S\selectlanguage{ngerman}önmez K, Türkyilmaz Z, Özen \selectlanguage{polish}İ\selectlanguage{english}O, Demiro\selectlanguage{polish}ğ\selectlanguage{english}ullar\selectlanguage{polish}ı \selectlanguage{english}B, G\selectlanguage{ngerman}üçlü
MM, et al. Second Branchial Anomalies in Children. Orl.
2005;67(3):160--2.

8. Rattan KN, Rattan S, Parihar D, Gulia JS, Yadav SPS. Second branchial
cleft fistula: is fistulogram necessary for complete excision. Int J
Pediatr Otorhinolaryngol. 2006 Jun;70(6):1027--30.

9. Schroeder JW, Mohyuddin N, Maddalozzo J. Branchial anomalies in the
pediatric population. Otolaryngol - Head Neck Surg. 2007;137(2):289--95.

10. Mitroi M, Dumitrescu D, Simionescu C, Popescu C, Mogoant\selectlanguage{romanian}ǎ C,
Cioroianu L, et al. Management of second branchial cleft anomalies. Rom
J Morphol Embryol. 2008;49(1):69--74.

11. Papadogeorgakis N, Petsinis V, Parara E, Papaspyrou K, Goutzanis L,
Alexandridis C. Branchial cleft cysts in adults. Diagnostic procedures
and treatment in a series of 18 cases. Oral Maxillofac Surg. 2009
Jun;13(2):79--85.

12. Bajaj, Pal AR, Al-Qudehy ZA, Rothera MP, Bruce IA. Branchial
anomalies in children. Otorhinolaryngologist. 2012;4(3):148--54.

13. Maddalozzo J, Rastatter JC, Dreyfuss HF, Jaffar R, Bhushan B. The
second branchial cleft fistula. Int J Pediatr Otorhinolaryngol.
2012;76(7):1042--5.

14. Zaifullah S, Yunus MRM, See GB. Diagnosis and treatment of branchial
cleft anomalies in UKMMC: a 10-year retrospective study. Eur Arch
Otorhinolaryngol. 2013 Mar;270(4):1501--6.

15. Erikci V, Ho\selectlanguage{polish}ş\selectlanguage{english}g\selectlanguage{ngerman}ör M. Management of congenital neck lesions in
children. J Plast Reconstr Aesthetic Surg. 2014;67(9).

16. Kajosaari L, Mäkitie A, Salminen P, Klockars T. Second branchial
cleft fistulae: Patient characteristics and surgical outcome. Int J
Pediatr Otorhinolaryngol. 2014;78(9):1503--7.

17. Prasad SC, Azeez A, Thada ND, Rao P, Bacciu A, Prasad KC. Branchial
anomalies: diagnosis and management. Int J Otolaryngol.
2014;2014:237015.

18. Spinelli C, Rossi L, Strambi S, Piscioneri J, Natale G, Bertocchini
A, et al. Branchial cleft and pouch anomalies in childhood: A report of
50 surgical cases. J Endocrinol Invest. 2016;39(5):529--35.

19. Kalra VK, Rattan KN, Yadav SPS, Bhukar S, Dheeraj S. Second
Branchial Anomalies: A Study of 94 Cases. Indian J Otolaryngol Head Neck
Surg. 2017 Dec;69(4):540--3.

\selectlanguage{english}
\FloatBarrier
\end{document}

