Shukla Janvi J, Morgan Sara, Wassef David, Manzi Brian
Otolaryngology - Head and Neck Surgery, Rutgers University New Jersey Medical School, Newark, USA.
Cureus. 2025 Jun 24;17(6):e86693. doi: 10.7759/cureus.86693. eCollection 2025 Jun.
Type IV branchial cleft anomalies, which can present as a cyst, sinus, or fistula, are the rarest type of branchial cleft anomalies. Although they can present at any age, they typically present during childhood with a history of frequent neck abscesses. Type IV branchial cleft anomalies usually occur on the left side near the medial lower border of the sternocleidomastoid (SCM) muscle and can extend to the pyriform sinus in the larynx. They can also present with thyroid involvement. Imaging with ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), sinogram, and direct laryngoscopy (DL) can aid in diagnosis. Sinus tracts, while not always present, may develop as a complication. Treatment is with surgical excision of the tract and debridement of the abscess in the setting of acute infection. Here, we present a rare case of right-sided type IV branchial cleft cyst in a seven-year-old boy who was treated primarily with ablation using Bugbee cauterization and drainage, avoiding the need for any further surgical intervention, including further drainage or thyroidectomy.
IV型鳃裂畸形可表现为囊肿、窦道或瘘管，是鳃裂畸形中最罕见的类型。尽管它们可在任何年龄出现，但通常在儿童期出现，有频繁颈部脓肿的病史。IV型鳃裂畸形通常发生在左侧，靠近胸锁乳突肌（SCM）内侧下缘，可延伸至喉部的梨状窦。它们也可伴有甲状腺受累。超声、计算机断层扫描（CT）、磁共振成像（MRI）、窦道造影和直接喉镜检查（DL）有助于诊断。窦道并不总是存在，但可能作为一种并发症出现。治疗方法是在急性感染时手术切除窦道并清创脓肿。在此，我们报告一例罕见的七岁男孩右侧IV型鳃裂囊肿病例，该病例主要采用Bugbee烧灼和引流进行消融治疗，避免了包括进一步引流或甲状腺切除术在内的任何进一步手术干预。
