From: Third or fourth branchial pouch sinus lesions: a case series and management algorithm
I | II | III | IV | V | |
---|---|---|---|---|---|
Cases (67 cases) [n (%)] | 25 (37.3%) | 16 (23.9%) | 18 (26.9%) | 1 (1.5%) | 7 (10.4%) |
Demographic | |||||
Female [n (%)] | 16 (64.0%) | 9 (56.3%) | 8 (44.4%) | 1 (100.0%) | 6 (85.7%) |
Age [median (range)] | 9y(1y-47y) | 8y(1y-35y) | 11.5y(1y-39y) | 16y(16y) | 21y(7y-42y) |
Site of presentation (n [%]) | |||||
Left | 22 (88.0%) | 14 (87.5%) | 8 (44.4%) | 0 (0.0%) | 2 (28.6%) |
Right | 0 (0.0%) | 1 (6.3%) | 7 (38.9%) | 1 (100.0%) | 5 (71.4%) |
Bilateral | 3 (12.0%) | 1 (6.3%) | 3 (16.7%) | 0 (0%) | 0 (0%) |
Initial presentation (n [%]) | |||||
Recurrent low-neck abscess | 24 (96.0%) | 14 (87.5%) | 2 (11.1%) | 1 (100%) | 1 (14.3%) |
Acute suppurative thyroiditis | 16 (64.0%) | 4 (25.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
Neck mass | 1 (4.0%) | 2 (12.5%) | 7 (38.9%) | 0 (0.0%) | 6 (85.7%) |
Cutaneous discharging fistula with neck infection | 11 (44.0%) | 4 (25.1%) | 9 (50.0%) | 0 (0.0%) | 2 (28.6%) |
Diagnostic investigations performed (n [%]) | |||||
Iopromide swallow (41 cases) | 15 (60.0%) | 6 (87.5%) | / | / | / |
Laryngoscopy (41 cases) | 21 (84.0%) | 10 (62.5%) | / | / | / |
CT scan (51 cases) | 22 (88.0%) | 14 (87.5%) | 8 (44.4%) | 1 (100.0%) | 4 (57.1%) |
Ultrasound (31 cases) | 13 (92.9%) | 9 (90.0%) | 4 (100.0%) | 1 (100.0%) | 2 (100.0%) |
MRI (13 cases) | 3 (100.0%) | 4 (100.0%) | 1 (50.0%) | 1 (100.0%) | 3 (100.0%) |
Treatment (n [%]) | |||||
Incision and drainage | 22 (88.0%) | 7 (43.8%) | 6 (33.3%) | 1 (100.0%) | 1 (14.3%) |
Open neck surgery after failure | 10 (40.0%) | 0 (0.0%) | 1 (5.6%) | 0 (0.0%) | 0 (0.0%) |
None | 3 (12.0%) | 9 (56.2%) | 9 (61.1%) | 0 (0.0%) | 6 (85.7%) |
Operating method (n [%]) | |||||
Type I | / | / | 18 (100.0%) | 1 (100.0%) | 7 (100.0%) |
Type II | / | 10 (62.5%) | / | / | / |
Type III | 16 (64.0%) | 5 (31.3%) | / | / | / |
Type IV | 9 (36.0%) | 1 (6.3%) | / | / | / |
Complication (n [%]) | |||||
Wound infection | 0 (0%) | 2 (12.5%) | 0 (0%) | 0 (0%) | 0 (0%) |
Esophageal injury | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
Voice hoarseness | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
Recurrence (n [%]) | 0 (0%) | 1 (6.25%) | 0 (0%) | 0 (0%) | 0 (0%) |