Erwin Dylan Z, Lesko David, Ferrell Jay K
Otolaryngology - Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA.
Cureus. 2022 Feb 10;14(2):e22098. doi: 10.7759/cureus.22098. eCollection 2022 Feb.
Fourth branchial cleft anomalies are an exceptionally rare cause of recurrent neck mass in pediatric and adult patients. In this report, we present a case of an infected fourth branchial cleft cyst in a 20-year-old woman that presented with recurrent throat pain and deep neck abscesses. After undergoing repeated incision and drainage procedures, the patient underwent definitive management with direct laryngoscopy, ablation of the left pyriform sinus tract, left hemithyroidectomy, and excision of the branchial anomaly without evidence of recurrence. In addition to diagnosis and management, this case report highlights the unique anatomical relationship between fourth branchial anomalies and the pyriform fossa as well as the superior and recurrent laryngeal nerves.
第四鳃裂畸形是儿童和成人复发性颈部肿块极为罕见的病因。在本报告中，我们呈现了一例20岁女性感染性第四鳃裂囊肿的病例，该患者表现为反复咽痛和颈部深部脓肿。在经历多次切开引流手术后，患者接受了直接喉镜检查、左侧梨状窦道切除术、左侧甲状腺叶切除术以及鳃裂畸形切除术等确定性治疗，术后无复发迹象。除了诊断和治疗外，本病例报告还突出了第四鳃裂畸形与梨状窝以及喉上神经和喉返神经之间独特的解剖关系。
