Lateral cervical sinus: specific sonographic findings in two pediatric cases

Area of Science:

• Pediatric Surgery
• Medical Imaging
• Congenital Anomalies

Background:

• Lateral cervical sinus, also known as a second pharyngeal or branchial cleft fistula/sinus, arises from incomplete embryonic development.
• This condition presents as a narrow canal on the lateral neck, anterior to the sternocleidomastoid muscle.

Observation:

• Two pediatric cases of LCS are presented, highlighting clinical presentation and diagnostic findings.
• Case 1: A 3-month-old boy with intermittent drainage from a lateral neck sinus.
• Case 2: A 1-month-old girl with signs of acute infection at a pinpoint sinus opening on the lateral neck.

Findings:

• Sonography revealed characteristic findings in both pediatric cases of LCS.
• In both cases, sonography demonstrated the sinus tract extending between the external and internal carotid arteries.
• Sonography identified an oval-shaped cystic lesion in one case.

Implications:

• Sonography is recommended as the initial diagnostic tool for LCS in children due to its non-invasive nature.
• Ultrasound avoids radiation and sedation, making it ideal for pediatric imaging.
• Sonography offers pathognomonic findings for LCS, differentiating it from other neck masses.