Third or fourth branchial pouch sinus lesions: a case series and management algorithm
Abstract Background The purpose of this study was to develop an effective management algorithm for lesions of third or fourth branchial sinuses. Study design Case series with chart review. Methods Data from patients who were identified as having third or fourth branchial pouch sinus lesions in a sin...
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SAGE Publishing
2019-11-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-019-0371-6 |
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| author | Yun Li Kexing Lyu Yihui Wen Yang Xu Fanqin Wei Haocheng Tang Siyu Chen Zhangfeng Wang Xiaolin Zhu Weiping Wen Wenbin Lei |
| author_facet | Yun Li Kexing Lyu Yihui Wen Yang Xu Fanqin Wei Haocheng Tang Siyu Chen Zhangfeng Wang Xiaolin Zhu Weiping Wen Wenbin Lei |
| author_sort | Yun Li |
| collection | DOAJ |
| description | Abstract Background The purpose of this study was to develop an effective management algorithm for lesions of third or fourth branchial sinuses. Study design Case series with chart review. Methods Data from patients who were identified as having third or fourth branchial pouch sinus lesions in a single institution between January 2014 and December 2018 were retrospectively collected. Results All 67 patients underwent fistulectomy. First, we classified the patients into five types based on their anatomic features. Then, we considered four optimized surgical methods and adopted the appropriate method with full consideration of the patient’s clinical characteristics. The great majority of cases occurred on the left side of the neck (68.7%) and most commonly presented as either a recurrent low-neck abscess or cutaneous discharging fistula with neck infection. Effective preoperative examination included administering contrast agent prior to a computed tomography (CT) scan and in-office laryngoscopy during the quiescent period of inflammation. Ultrasound was also very helpful in determining the presence of thyroiditis. The mean follow-up duration after excision of the lesion was 25.8 months. To date, only 1 (1.5%) recurrence and no obvious complications have been observed. Conclusion Refining fistula subtypes and adopting corresponding treatment measures can reduce the recurrence rate and improve curative effects. We propose and advocate this treatment algorithm for all third and fourth branchial pouch lesions. |
| format | Article |
| id | doaj-art-d9d6bae598bc4a1caa569e021bb6f0d2 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-d9d6bae598bc4a1caa569e021bb6f0d22025-01-03T01:45:57ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162019-11-014811910.1186/s40463-019-0371-6Third or fourth branchial pouch sinus lesions: a case series and management algorithmYun Li0Kexing Lyu1Yihui Wen2Yang Xu3Fanqin Wei4Haocheng Tang5Siyu Chen6Zhangfeng Wang7Xiaolin Zhu8Weiping Wen9Wenbin Lei10Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen UniversityAbstract Background The purpose of this study was to develop an effective management algorithm for lesions of third or fourth branchial sinuses. Study design Case series with chart review. Methods Data from patients who were identified as having third or fourth branchial pouch sinus lesions in a single institution between January 2014 and December 2018 were retrospectively collected. Results All 67 patients underwent fistulectomy. First, we classified the patients into five types based on their anatomic features. Then, we considered four optimized surgical methods and adopted the appropriate method with full consideration of the patient’s clinical characteristics. The great majority of cases occurred on the left side of the neck (68.7%) and most commonly presented as either a recurrent low-neck abscess or cutaneous discharging fistula with neck infection. Effective preoperative examination included administering contrast agent prior to a computed tomography (CT) scan and in-office laryngoscopy during the quiescent period of inflammation. Ultrasound was also very helpful in determining the presence of thyroiditis. The mean follow-up duration after excision of the lesion was 25.8 months. To date, only 1 (1.5%) recurrence and no obvious complications have been observed. Conclusion Refining fistula subtypes and adopting corresponding treatment measures can reduce the recurrence rate and improve curative effects. We propose and advocate this treatment algorithm for all third and fourth branchial pouch lesions.http://link.springer.com/article/10.1186/s40463-019-0371-6Congenital branchial anatomiesFistula tract excisionPyriform sinusRecurrent neck abscessesThyroiditis |
| spellingShingle | Yun Li Kexing Lyu Yihui Wen Yang Xu Fanqin Wei Haocheng Tang Siyu Chen Zhangfeng Wang Xiaolin Zhu Weiping Wen Wenbin Lei Third or fourth branchial pouch sinus lesions: a case series and management algorithm Journal of Otolaryngology - Head and Neck Surgery Congenital branchial anatomies Fistula tract excision Pyriform sinus Recurrent neck abscesses Thyroiditis |
| title | Third or fourth branchial pouch sinus lesions: a case series and management algorithm |
| title_full | Third or fourth branchial pouch sinus lesions: a case series and management algorithm |
| title_fullStr | Third or fourth branchial pouch sinus lesions: a case series and management algorithm |
| title_full_unstemmed | Third or fourth branchial pouch sinus lesions: a case series and management algorithm |
| title_short | Third or fourth branchial pouch sinus lesions: a case series and management algorithm |
| title_sort | third or fourth branchial pouch sinus lesions a case series and management algorithm |
| topic | Congenital branchial anatomies Fistula tract excision Pyriform sinus Recurrent neck abscesses Thyroiditis |
| url | http://link.springer.com/article/10.1186/s40463-019-0371-6 |
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