Third branchial cleft sinus: an unusual cause of neck abscess

Sinuses and fistulae of the third branchial cleft or pouch are rarely encountered. We have cared for a child with a history of multiple neck masses and abscesses, in whom the causative factor seems to have been an unrecognized branchial cleft sinus. This case suggests the need for contrast radiography of the hypopharynx in children with recurrent neck abscess, and dramatizes the need to exercise all reasonable diagnostic options before proceeding with surgery of newly presenting neck masses in children.