OBJECTIVES: 1) Demonstrate the surgical anatomy of a fourth branchial cleft sinus relative to the superior and recurrent laryngeal nerves. 2) Review the diagnosis and management of a fourth branchial cleft sinus. DESIGN: Case Study. SETTING: Tertiary Children's Hospital. PATIENT: Three year old female who presented with a fever and painful right neck mass. CT scan demonstrated a right neck abscess containing air adjacent to the thyroid. INTERVENTION: Two months after initial drainage, the patient underwent enbloc excision of the sinus including the thyroid lobe with closure of the piriform sinus defect. MAIN OUTCOME MEASURE: Intraoperative photo documentation of the anatomic relationship between the fourth branchial sinus and surrounding neural structures. RESULTS: The sinus tract was shown to terminate in the piriform sinus inferior to the superior laryngeal nerve.
OBJECTIVES: 1) Demonstrate the surgical anatomy of a fourth branchial cleft sinus relative to the superior and recurrent laryngeal nerves. 2) Review the diagnosis and management of a fourth branchial cleft sinus. DESIGN: Case Study. SETTING: Tertiary Children's Hospital. PATIENT: Three year old female who presented with a fever and painful right neck mass. CT scan demonstrated a right neck abscess containing air adjacent to the thyroid. INTERVENTION: Two months after initial drainage, the patient underwent enbloc excision of the sinus including the thyroid lobe with closure of the piriform sinus defect. MAIN OUTCOME MEASURE: Intraoperative photo documentation of the anatomic relationship between the fourth branchial sinus and surrounding neural structures. RESULTS: The sinus tract was shown to terminate in the piriform sinus inferior to the superior laryngeal nerve.