Management of Congenital Third Branchial Arch Anomalies: A Systematic Review

Abstract

Third arch anomalies are more common than previously reported. They appear to be best treated by complete excision of the cyst, sinus, or fistula during a quiescent period. Repeated incision and drainage yields high rates of recurrence and should be avoided. Complications might be minimized by first initiating antibiotic treatment, delaying surgical treatment until the inflammatory process is maximally resolved, and by using endoscopic cauterization.

Distribution of branchial anomalies in a paediatric Asian population

“…If present, the external opening can be found over the anterior border of the sternocleidomastoid muscle, between the middle and lower third. (13,14) In theory, fourth branchial arch anomalies follow a more convoluted route than third branchial arch anomalies. The former originate from the apex of the pyriform sinus medial to the superior laryngeal nerve, and travel inferiorly in the tracheoesophageal groove, behind the thyroid gland and parallel to the recurrent laryngeal nerve into the mediastinum, where they loop around the aorta on the left and subclavian artery on the right.…”

Rapidly Enlarging Neck Mass in a Neonate Causing Airway Compromise

“…While ultrasound has a low predictive power for third or fourth branchial cleft anomalies, ultrasound imaging in this case was used to eliminate venolymphatic malformations and fi bromatosis colli from the diff erential diagnosis ( 5 ). CT is the most common diagnostic tool for branchial anomalies, with a positive branchial anomaly identifi cation rate as high as 64% ( 5 -9 ).…”

Endoscopic Chemocauterization Of Congenital Piriform Fossa Sinus Tract In Children

“…On the other hand, branchial sinuses will communicate either with the pharyngeal lumen or the skin and brachial fistulas will form tract connecting the skin and pharynx. 2 There are only about 1-4% incidence of fourth branchial anomaly reported in the literature, which carries about less than 100 cases of all branchial arch anomalies. The fourth branchial arch anomalies usually presented with acute supurative thyroiditis (45%) and recurrent neck abscess (42%) with the left side predominant (94%).…”

“…The fourth branchial arch anomalies usually presented with acute supurative thyroiditis (45%) and recurrent neck abscess (42%) with the left side predominant (94%). 2 The left sided predominance is probably due to its more complex and extended pathway of the fourth branchial arch tract as compared to the right side. It might also due to absence or involution of the ultimobrachial body on the right side.…”

“…It might also due to absence or involution of the ultimobrachial body on the right side. 2 We present a case of congenital piriform fossa sinus tract that was managed by endoscopic chemocauterization using silver nitirite 20% and tricholoroacetone 20% solution. Case report An eight years old boy was referred to our clinic for persistant anterior neck discharge since four years ago.…”