Management of a recurrent third branchial arch fistula using combined endoscopic and open approach

Authors

  • Meenu Krishnan Department of Otorhinolaryngology, Manipal Hospitals Whitefield, Bengaluru, Karnataka, India
  • Anitha Kumari Department of Otorhinolaryngology, Manipal Hospitals Whitefield, Bengaluru, Karnataka, India
  • Ramani C. V. Department of Plastic Surgery, Manipal Hospitals, Whitefield, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20240078

Keywords:

Branchial arch fistula, Third arch fistula, Recurrent branchial fistula

Abstract

Branchial cleft anomalies are rare, congenital lesions, that occur due to the maldevelopment of the branchial apparatus, during fetal maturation. Anomalies of the third and fourth arch contribute to a very small proportion of these. Most cases are detected in childhood, either as a cyst, sinus or fistula in the neck. Some of the common treatment approaches to third branchial cleft fistulas include endoscopic cauterization, open cervical fistulectomy and, in cases of recurrence, selective neck dissection. Here, we present a case of recurrent branchial fistula of the third arch, wherein we used a combined cervical and intraoral approach, conserving the thyroid cartilage, to achieve a complete excision of the fistula tract.

References

Nicoucar K, Giger R, Jaecklin T, Pope HG Jr, Dulguerov P. Management of congenital third branchial arch anomalies: a systematic review. Otolaryngol Head Neck Surg. 2010;142:21-8.

Prosser JD, Myer CM. Branchial cleft anomalies and thymic cysts. Otolaryngol Clin North Am. 2015;48(1):1-14.

Mandell DL. Head and neck anomalies related to the branchial apparatus. Otolaryngol Clin North Am. 2000;33:1309-32.

Bajaj Y, Ifeacho S, Tweedie D, Jephson CG, Albert DM, Cochrane LA, et al. Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 2011;75:1020-3.

James A, Stewart C, Warrick P, Tzifa C, Forte V. Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies. Laryngoscope. 2007;117:1920-4.

Derks LS, Veenstra HJ, Oomen KP, Speleman L, Stegeman I. Surgery versus endoscopic cauterization in patients with third or fourth branchial pouch sinuses: a systematic review. Laryngoscope. 2016;126:212-7.

Nicoucar K, Giger R, Pope HG Jr, Jaecklin T, Dulguerov P. Management of congenital fourth branchial arch anomalies: a review and analysis of published cases. J Pediatr Surg. 2009;44:1432-9.

Li L, Liu J, Lv D, Shen T, Deng D, Wang J, Chen F. The utilization of selective neck dissection in the treatment of recurrent branchial cleft anomalies. Medicine (Baltimore). 2019;98(33):e16799.

Choi SS, Zalzal GH. Branchial anomalies: a review of 52 cases. Laryngoscope. 1995;105:909-13.

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Published

2024-01-25