Fourth branchial cleft anomaly in a 7-month-old infant: A case report and literature review

Area of Science:

• Pediatric Surgery
• Congenital Head and Neck Anomalies
• Otolaryngology

Background:

• Fourth branchial cleft anomalies are uncommon congenital malformations.
• These lesions typically manifest as inflammatory neck masses, predominantly on the left side.
• They can present with significant complications, including airway compromise.

Purpose of the Study:

• To report a rare case of an incomplete fourth branchial cleft fistula in an infant.
• To describe the clinical presentation and diagnostic findings.
• To detail the surgical and endoscopic management strategies employed.

Main Methods:

• A 7-month-old female presented with a neck mass and respiratory distress.
• Diagnosis of an incomplete fourth branchial cleft fistula was established.
• Treatment involved surgical revision of a neck abscess and endoscopic plasma coblation of the pyriform fossa orifice.

Main Results:

• The patient presented with a congenital neck mass causing respiratory distress.
• An incomplete fourth branchial cleft fistula was diagnosed.
• Combined surgical and endoscopic treatment successfully addressed the anomaly.

Conclusions:

• Incomplete fourth branchial cleft fistulas are rare but critical congenital anomalies.
• A combined surgical and endoscopic approach can be effective for managing these complex pediatric neck lesions.
• Early diagnosis and intervention are crucial for favorable outcomes.