Branchiogenous anomalies are of interest because of the varying clinical pictures they present after secondary infection or occlusion. Although the diagnosis of a branchiogenous anomaly may be evident, at times, it is difficult to evaluate the depth or extent of the associated tract. The differential diagnosis includes tuberculous and nontuberculous lymphadenitis, other infectious processes, tumors of the carotid, hygroma, dermoid cysts, lipomas, neurofibromas, hemangiomas, and lymphangiomas. Thorough surgical evaluation and competent extirpation should be carried out. Inadequate treatment of these lesions by sclerosing agents, such as phenol, or by incomplete electrosurgical measures often results in partial obliteration of these tracts, with subsequent secondary infection and unnecessary scarring and disfigurement.