US performed by a skilled operator is a reliable tool for adenoma localization prior to minimally invasive parathyroidectomy. If the US findings are inconclusive, a Tc-sestamibi scan should be used. If there is a high clinical suspicion of adenoma in the presence of negative imaging studies, bilateral neck exploration should be performed.
Heterotopic salivary tissue and branchial sinuses occur not infrequently (Goddman et al., 1981; Stingle and Priebe, 1974), caused probably by heteroplasia within remants of the second cleft (Stingle, 1974). Bilateral lesions which presented clinically as branchial cleft sinuses have been removed from a patient's neck; both of them proved to be branchial cleft sinuses with elements of slivary tissue.The paper describes sailvary tissue and branchial sinuses along the anterior border of the sternocleidomastoid muscle on both sides of the neck and bilateral preauricular fistulae occurring in a boy and probably in his sister.
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