Management of congenital fourth branchial arch anomalies: a review and analysis of published cases

Nicoucar, Keyvan; Giger, Roland; Pope, Harrison G.; Jaecklin, Thomas; Dulguerov, Pavel

doi:10.1016/j.jpedsurg.2008.12.001

Cited by 215 publications

(325 citation statements)

References 37 publications

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“…Las fístulas del seno piriforme son una entidad poco frecuente, por lo que requieren una alta sospecha clínica, para poder llegar a su diagnóstico 1,3,4 . Estas se presentan en un 95% de los casos a la izquierda y clínicamente se pueden presentar como aumento de volumen cervical, fístula cervical, absceso cervical, tiroiditis abscedada y/o disfonía 1,4 .…”

Section: Discussionunclassified

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

et al. 2018

Rev Chil Cir

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Introduction:Pyriform sinus fistula is a rare cervical branchial anomaly derived from the third and fourth branchial arch. Pyriform sinus fistula should be considered in children presenting enlarged neck mass, fistula, abscess, thyroid infection and/or dysphonia. Objective: We here report 4 cases treated in Hospital Clí-nico Universidad de Chile and review of the current literature on pyriform sinus fistula. Discussion: When clinical presentation is compatible with pyriform sinus fistula, endoscopic and imaging techniques are required. Surgical outcomes are better, although endoscopic therapies and combination of both surgery and endoscopy have also reported good outcomes. Conclusion: Diagnosis is made based on signs and symptoms and a high index of clinical suspicion. Open surgery is gold standard, however in pediatric population endoscopic resolution should be considered to reduce the high morbidity of traditional surgery.

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Section: Discussionunclassified

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

et al. 2018

Rev Chil Cir

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“…A recurrent lateral neck abscess (42%) and suppurative thyroiditis (45%) are the most common presentations [6], although upper respiratory infections, recurrent retropharyngeal abscess and cellulitis, odynophagia, stridor, and mediastinitis as presenting features have also been reported [1,[7][8][9][10]. Approximately 93-97% of fourth pouch anomalies are left sided [2,3,5,6,11] which may be related to the absence or involution of the ultimobranchial body on the right side, in addition to asymmetric vascular agenesis during fourth arch development [6,9,10]. Females are slightly more prone, and age at diagnosis ranges from birth to adulthood [1,11].…”

Section: Discussionmentioning

confidence: 99%

“…Gas within the area of the left upper pole of the thyroid gland on ultrasound is considered pathognomonic of a pyriform fossa sinus [6].…”

Section: Discussionmentioning

confidence: 99%

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Right‐Sided Pyriform Sinus Fistula: A Case Report and Review of the Literature

2011

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Objectives. Pyriform sinus fistulae arise from disturbances in the development of the fetal third and fourth branchial pouches and are predominantly found on the left side. We report the rare case of a right-sided pyriform sinus fistula presenting as a lateral neck abscess. Study Design. Case report. Methods. A 24-year-old woman presented with a two-week history of right-sided neck abscess. A fluoroscopic sinogram revealed a fistulous tract extending from the abscess to the apex of the right pyriform sinus. It was determined that the fistula was likely a third or fourth branchial remnant, a rare right-sided finding. Chemocauterization of the fistulous tract with 40% trichloroacetic acid was used to successfully treat the patient. Results. Approximately 93-97% of branchial pouch anomalies are left sided. Treatment options include surgical excision and cauterization. Conclusions. Branchial cleft cyst and pyriform sinus fistula must be considered in the diagnosis of cervical abscess in either side of the neck.

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“…5 AST specially affects patients with thyroid gland pathology such as Hashimoto's thyroiditis or thyroid cancer and in children is associated with local anatomic defects. 4,6 In particular the condition is associated with the persistence of a canal originating from the 3 th or 4 th bronchial pouch that may lead to recurrent thyroid abscess. 7,8 In most cases the infection spreads to thyroid gland via piriform sinus fistula.…”

Section: Introductionmentioning

confidence: 99%

Outcome of ultrasound guided closed drainage of acute suppurative thyroid abscess as a definitive treatment modality

Ravi

Bhat

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Thyroid abscess are relatively uncommon conditions in otolaryngology-head and neck surgery because of thyroid glands anatomical and physiological protective barrier. When it occurs it results in significant morbidity with potential mortality. Traditionally, surgical incision and drainage with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound guided closed drainage is a less invasive and effective alternative in selected cases. The aim of our study is to evaluate the efficacy of ultrasound guided percutaneous closed drainage in the management of thyroid abscess. Methods: From January 2013 to December 2016, patients presenting with thyroid abscess to the department of otolaryngology at Adichunchanagiri hospital and who subsequently underwent ultrasound guided percutaneous closed drainage were included in the study. Results: Five patients were recruited for the study. After the aspiration of pus under ultrasound guidance, all patients were symptomatically improved and no patients needed open surgical drainage afterwards. After treatment, all patients were cured of their disease completely without any complications and with reduced hospital stay. After discharge, no patient showed any signs of relapse on regular follow-up. Conclusions: Ultrasound guided percutaneous closed drainage of thyroid abscess is an effective and safe procedure because of good clinical outcome, patient satisfaction and reduced hospital stay. It is an effective alternative to open incision and drainage of thyroid abscess.

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Management of congenital fourth branchial arch anomalies: a review and analysis of published cases

Cited by 215 publications

References 37 publications

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

Fístulas del seno piriforme congénitas. Reporte de 4 casos y revisión de la literatura

Right‐Sided Pyriform Sinus Fistula: A Case Report and Review of the Literature

Outcome of ultrasound guided closed drainage of acute suppurative thyroid abscess as a definitive treatment modality

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