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Fourth branchial arch fistula and suppurative thyroiditis: a life-threatening infection

Published online by Cambridge University Press:  08 March 2006

Satvir S. Minhas ,
John C. Watkinson  and
Jayne Franklyn
Satvir S. Minhas
Affiliation:
Departments of Otolaryngology and Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham
John C. Watkinson
Affiliation:
Departments of Otolaryngology and Head and Neck Surgery, Queen Elizabeth Hospital, Birmingham
Jayne Franklyn
Affiliation:
Division of Medical Sciences, University of Birmingham, UK
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Abstract

A potentially life-threatening case of recurrent left-sided thyroid abscess formation secondary to a fourth branchial arch sinus fistula is presented. The patient developed a reversible left vocal fold palsy during an acute episode of suppurative thyroiditis requiring a temporary tracheostomy due to a compromised airway. Investigations commonly used to demonstrate this anomaly may fail to confirm the diagnosis as in the case presented and exploratory surgery with excision of the fistulous tract should still be considered. We describe a method of repairing the pharyngeal opening to reduce the risk of recurrence or pharyngeal leak.

Keywords

AbscessBranchial ArchesThyroiditisSuppurativeVocal Cord Paralysis
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 115 , Issue 12 , December 2001 , pp. 1029 - 1031
Copyright
© Royal Society of Medicine Press Limited 2001

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