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Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies.
Laryngoscope. 2007 Nov; 117(11):1920-4.L

Abstract

OBJECTIVE

The objective of this study was to review clinical and embryologic aspects of third and fourth branchial anomalies.

STUDY DESIGN

Retrospective study.

METHODS

We reviewed the institutional and departmental databases at our institution to identify all cases of third and fourth branchial anomalies encountered from 1992 to 2006. All patient records were examined with respect to demographics, clinical history, and radiologic and pathologic reports.

RESULTS

We identified 17 cases of third and fourth branchial anomalies, the largest series of its kind reported to date. The lesions were predominantly left sided, all presenting with neck infection. Fistula formation was iatrogenic, secondary to incision and drainage. Preoperative direct laryngoscopy always revealed a pit within the apex of the piriform fossa. Surgical excision involved ipsilateral thyroidectomy as the lesion passed through the thyroid gland. No lesions following the classical course of a either a third or fourth branchial anomaly were identified.

CONCLUSIONS

The clinical presentation of branchial sinuses arising from the piriform fossa is more in keeping with derivation from the thymopharyngeal duct (of the third pouch) than the hypothetical course of third and fourth branchial fistulae.

Authors+Show Affiliations

Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada. adr.james@utoronto.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17878800

Citation

James, Adrian, et al. "Branchial Sinus of the Piriform Fossa: Reappraisal of Third and Fourth Branchial Anomalies." The Laryngoscope, vol. 117, no. 11, 2007, pp. 1920-4.
James A, Stewart C, Warrick P, et al. Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies. Laryngoscope. 2007;117(11):1920-4.
James, A., Stewart, C., Warrick, P., Tzifa, C., & Forte, V. (2007). Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies. The Laryngoscope, 117(11), 1920-4.
James A, et al. Branchial Sinus of the Piriform Fossa: Reappraisal of Third and Fourth Branchial Anomalies. Laryngoscope. 2007;117(11):1920-4. PubMed PMID: 17878800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies. AU - James,Adrian, AU - Stewart,Craig, AU - Warrick,Paul, AU - Tzifa,Constance, AU - Forte,Vito, PY - 2007/9/20/pubmed PY - 2008/1/8/medline PY - 2007/9/20/entrez SP - 1920 EP - 4 JF - The Laryngoscope JO - Laryngoscope VL - 117 IS - 11 N2 - OBJECTIVE: The objective of this study was to review clinical and embryologic aspects of third and fourth branchial anomalies. STUDY DESIGN: Retrospective study. METHODS: We reviewed the institutional and departmental databases at our institution to identify all cases of third and fourth branchial anomalies encountered from 1992 to 2006. All patient records were examined with respect to demographics, clinical history, and radiologic and pathologic reports. RESULTS: We identified 17 cases of third and fourth branchial anomalies, the largest series of its kind reported to date. The lesions were predominantly left sided, all presenting with neck infection. Fistula formation was iatrogenic, secondary to incision and drainage. Preoperative direct laryngoscopy always revealed a pit within the apex of the piriform fossa. Surgical excision involved ipsilateral thyroidectomy as the lesion passed through the thyroid gland. No lesions following the classical course of a either a third or fourth branchial anomaly were identified. CONCLUSIONS: The clinical presentation of branchial sinuses arising from the piriform fossa is more in keeping with derivation from the thymopharyngeal duct (of the third pouch) than the hypothetical course of third and fourth branchial fistulae. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/17878800/Branchial_sinus_of_the_piriform_fossa:_reappraisal_of_third_and_fourth_branchial_anomalies_ L2 - https://doi.org/10.1097/MLG.0b013e31813437fc DB - PRIME DP - Unbound Medicine ER -