Third branchial cleft anomalies are rare congenital abnormalities with a complicated anatomic course. The traditional standard of treatment is complete open excision of the entire tract, but newer endoscopic and combined approaches are becoming more common. We summarize the anatomy, presentation, and evaluation of these anomalies. A review of the literature regarding the various surgical options and their associated risks and benefits is discussed. We then review the details of open excision, endoscopic treatment, and combined open/endoscopic surgical options.
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