Treatment of a branchial sinus tract by sclerotherapy

Abstract

A 16-year-old female presented with a sinus on the skin just medial to the right clavicle, which had discharged clear fluid on a daily basis for a number of years. A sinogram was performed and showed a long sinus tract extending from the region of the right clavicle to the lateral pharyngeal wall. Surgical treatment would have required an extensive procedure and seemed inappropriate in view of the relatively mild symptoms the patient was experiencing. Instead sclerotherapy was used to induce healing of the lesion. This was performed using 3% sodium tetradecyl sulphate foam delivered via a catheter along the entire length of the tract. There were no immediate complications from this procedure and on review at 1 and 6 weeks postprocedure the patient reported a significant improvement in the fluid discharge. At 1 year post-procedure this improvement had been sustained. The patient did report an occasional discharge from the sinus tract orifice at the base of her neck, but she did not feel that this was a significant problem and declined any further treatment.

Efficacy and Safety of Ethanol Ablation for Branchial Cleft Cysts

“…In addition, surgeons may be reluctant to undertake open surgical treatment, which might seem inappropriate, particularly in view of the often relatively mild symptomatology. 19 Alternative treatment of BCCs, specifically US-guided chemical ablation with OK-432 or EA, has been suggested to over-come the limitations of surgery. The main advantages of US-guided chemical ablation are the absence of external scarring and the low morbidity and complication rates.…”

Clinical Study on the Etiology of Postthyroidectomy Skin Sinus Formation

“…Reducing skin sinus formation after thyroidectomy may be related with more accurate knowledge of the thyroid anatomy and skilled surgical handling and sterile technique. Treatment methods of common sinus tracts include chemocauterization [18], sclerotherapy [19], negative pressure wound therapy [20], and complete excision of the fistula. For the patients with cervical sinus formation after the thyroid surgery, adequate drainage, anti-inflammatory, and symptomatic treatment can be used during the acute phase of inflammation frequent dressings; but they should not undergo surgery.…”

An Interesting Fistula Tract Presenting with Recurrent Gluteal Abscess: Instructive Case

“…Sclerotherapy using bleomycin is an established technique for the treatment of developmental vascular anomalies, also those which are at risk of developing intraoperative damage to vital organs and nerves, and lymphangiomas. Now sclerotherapy has been successfully used in the treatment of congenital sinus tracts [ 8 – 10 ]. Bleomycin is an antitumor agent and, besides its antineoplastic effect, bleomycin causes nonspecific inflammatory reaction leading to fibrosis in the surrounding tissues [ 10 ].…”