Branchial anomaly in a newborn presenting as stridor

Area of Science:

• Pediatric Surgery
• Neonatal Medicine
• Medical Genetics

Background:

• Branchial anomalies are rare congenital malformations.
• Third branchial anomalies are exceptionally rare, often presenting with recurrent infections or airway compromise.

Observation:

• A male neonate presented on day 3 of life with an anterior neck mass and intermittent upper airway obstruction.
• The condition rapidly worsened, leading to impending airway obstruction despite antibiotic treatment.

Findings:

• Surgical intervention was required due to the severity of the airway obstruction.
• Clinical, radiographic, and histologic findings confirmed an extremely rare third branchial anomaly.
• The anomaly provided a pathway for gram-negative enteric organisms.

Implications:

• Understanding the embryologic basis is crucial for diagnosis and management.
• This case highlights the potential for severe airway compromise in neonates with branchial anomalies.
• Early recognition and surgical intervention are vital for favorable outcomes.