A retrospective study of cervical chondrocutaneous branchial remnants

BACKGROUND: Cervical chondrocutaneous branchial remnants (CCBRs) are rare developmental anomalies that arise during early embryogenesis. Because of their rarity, most published reports consist of small case series, and no standardized classification system has been established. The purpose of this study was to define the standardized clinical characteristics of CCBRs and to propose a comprehensive classification system based on the largest cohort reported to date. METHODS: We retrospectively reviewed 55 CCBRs in 53 patients who underwent surgical excision between 2014 and 2023. Data collected included sex, age at diagnosis, age at surgery, associated anomalies, pathological findings, laterality, anatomical location, morphological shape, and intraoperative characteristics. All CCBRs were bounded superiorly by the inferior border of the thyroid cartilage, inferiorly by the upper border of the sternoclavicular junction, and laterally by the posterior border of the sternocleidomastoid muscle (SCM). Location was divided into three zones: "central" above the trachea, "medial" between the trachea and SCM, and "lateral" over the SCM. Morphology was classified by protrusion pattern-pedunculated or sessile-and further categorized as spherical, ovoid, lobed, or nodular according to cross-sectional geometry. RESULTS: A total of 55 CCBRs were identified. No significant differences were observed in sex distribution (male 53%, female 47%) or laterality (right 50.9%, left 49.1%). Histopathological examination revealed elastic cartilage in all evaluated specimens. Associated congenital anomalies were minimal (7.5%), and no serious systemic anomalies were identified. Medial lesions were most common (47%), followed by lateral (38%). Sessile lesions (60%) were more frequent than pedunculated lesions (40%). Ovoid configuration was most common (36%), followed by nodular (25%) and spherical (23%). CONCLUSION: This study presents a standardized, globally applicable classification system for CCBRs, facilitating comparative research and promoting unified nomenclature for international academic communication.