Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T08:07:29.829Z Has data issue: false hasContentIssue false
  • English
  • Français

Complete congenital third branchial fistula with left-sided, recurrent, suppurative thyroiditis

Published online by Cambridge University Press:  16 February 2010

J Madana ,
D Yolmo ,
S Gopalakrishnan  and
S K Saxena
J Madana*
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
D Yolmo
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
S Gopalakrishnan
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
S K Saxena
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
*
Address for correspondence: Dr J Madana, Senior Resident, Department of Otorhinolaryngology, JIPMER, Pondicherry 605006, India. E-mail: maddyy@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We report an extremely rare case of a complete congenital third branchial arch fistula in a nine-year-old boy.

Method:

A case report and a review of the English literature concerning third branchial arch fistula of congenital origin are presented.

Results:

A nine-year-old boy presented with a history of a small opening in the middle third of the anterior neck since birth, with recurrent surrounding swelling. There was no history of surgical drainage or spontaneous rupture. Computed tomography with contrast injection into the external cervical opening revealed a patent tract from the neck skin to the base of the pyriform sinus. Complete excision of the tract up to the pyriform sinus with left hemithyroidectomy was performed. Follow up at 22 months showed no recurrence.

Conclusion:

To our knowledge, this case represents a very rare occurrence of the congenital variety of complete third branchial arch fistula at an unusual site. This case indicates that third branchial arch fistula can be complete, and may present in the anterior neck, an unusual site. In such cases, computed tomography fistulography and injection of dye into the pyriform sinus enables intra-operative delineation of the tract.

Keywords

Branchial ArchThyroiditisHemithyroidectomyPyriform SinusFistula
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 1025 - 1029
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Chaudhary, N, Gupta, A, Motwani, G, Kumar, S. Fistula of the fourth branchial pouch. Am J Otolaryngol 2003;24:250–2CrossRefGoogle ScholarPubMed
2Jaka, RC, Singh, G. Complete congenital third branchial fistula on right side. Otolaryngol Head Neck Surg 2007;137:518–19CrossRefGoogle ScholarPubMed
3James, A, Stewart, C, Warrick, P, Tzifa, C, Forte, V. Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies. Laryngoscope 2007;117:1920–4CrossRefGoogle ScholarPubMed
4Nicoucar, K, Giger, R, Pope, HG Jr, Jaecklin, T, Dulguerov, P. Management of congenital fourth branchial arch anomalies: a review and analysis of published cases. J Pediatr Surg 2009;44:1432–9CrossRefGoogle ScholarPubMed
5Mali, VP, Prabhakaran, K. Recurrent acute thyroid swellings because of pyriform sinus fistula. J Pediatr Surg 2008;43:e27–30CrossRefGoogle ScholarPubMed
6Kubota, M, Suita, S, Kamimura, T, Zaizen, Y. Surgical strategy for the treatment of pyriform sinus fistula. J Pediatr Surg 1997;32:34–7CrossRefGoogle ScholarPubMed
7Liberman, M, Kay, S, Emil, S, Flageole, H, Nguyen, LT, Tewfik, TL et al. Ten years of experience with third and fourth branchial remnants. J Pediatr Surg 2002;37:685–90CrossRefGoogle ScholarPubMed
8Garrel, R, Jouzdani, E, Gardiner, Q, Makeieff, M, Mondain, M, Hagen, P et al. Fourth branchial pouch sinus: from diagnosis to treatment. Otolaryngol Head Neck Surg 2006;134:157–63CrossRefGoogle ScholarPubMed