Abstract: Objective To explore the diagnosis and treatment of the congenital first branchial cyst and fistula. Method The clinical data of 18 patients with first branchial cyst and fistula were retrospectively analyzed. Results Among them, 10 had first branchial fistulas, of which the external blind fistula was between the earlobe and mastoid process and 6 patients， of which the internal blind fistula located in the boundary of bone and cartilage was in the posterior and lower wall of the external auditory meatus. 8 patients had a branchial cleft cyst, in which the cyst was located in the posterior earlobe in 4 patients, the mandibular angle in 2 patients and the fascia of the parotid gland in 2 patients. All cysts and fistulas were surgically removed. 16 patients were followed up and they thoroughly recovered. Conclusions Congenital first branchial cleft cyst and fistula are rare in the clinic and are easily misdiagnosed and mistreated. Definite diagnosis before operation depends on imaging. The key to cure the diseases is a reasonable operative procedure and complete surgical resection is important for avoiding recurrence.

Key words: Branchial cleft cyst, Branchial cleft fistula, Diagnose, Surgical operation