Related Experiment Videos

Recurrent neck infection with branchial arch fistula in children

J Madana1, Deeke Yolmo, R Kalaiarasi

  • 1Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605 006, India. maddyy@gmail.com

International Journal of Pediatric Otorhinolaryngology
|July 19, 2011
PubMed

Insights

Recurrent neck infections in children may indicate a branchial arch fistula, specifically a pyriform sinus fistula. Surgical excision of the tract and hemithyroidectomy offers a definitive cure with no recurrence.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Medical Imaging

Background:

  • Third and fourth branchial arch anomalies, including pyriform sinus fistulas (PSF), are rare causes of recurrent neck infections in children.
  • These infections often present unilaterally, typically on the left side, and can mimic other inflammatory conditions.

Purpose of the Study:

  • To present the experience with surgical management of third and fourth branchial arch origin pyriform sinus fistulas.
  • To evaluate the diagnostic utility of imaging modalities and the efficacy of surgical intervention for PSF.

Main Methods:

  • A retrospective review of 18 pediatric patients with PSF treated between 2005 and 2010.
  • Diagnosis was confirmed via radiological (CT fistulography, barium swallow, ultrasound) and intraoperative findings with pathological correlation.
  • All patients underwent neck exploration with complete fistulous tract excision and left hemithyroidectomy.

Main Results:

  • Eighteen patients (7 males, 11 females; ages 3-15) presented with recurrent left-sided neck infections.
  • CT fistulography, barium swallow, and ultrasound were valuable in preoperative tract delineation.
  • Surgical excision and hemithyroidectomy were successful in all cases, with no recurrence during a 1-3 year follow-up.

Conclusions:

  • Recurrent neck infections in children warrant consideration of underlying pyriform sinus fistulas of branchial origin.
  • CT fistulography post-infection resolution is crucial for anatomical tract delineation.
  • Surgical management provides a definitive treatment for PSF, preventing recurrence.
Abstract

Related Concept Videos

Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
Acute Pharyngitis01:30

Acute Pharyngitis

Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
The Arch of Aorta01:10

The Arch of Aorta

The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...