Recurrent thyroid abscess — Is it a fourth branchial archanomaly?

摘要

Branchial fistulae are of congenital origin6 and consists of skin lined tract opening internally at junction of cartilaginous and bony meatus in case of 1st arch anomaly, tonsillar fossa in case of 2nd arch, while 3rd and 4th arch sinuses have internal opening at level of pyriform sinus or below. A complete tract of 3rd or 4th arch fistulae is yet to be described. Fourth arch fistulae1 have a distinct clinical pattern of internal opening at pyriform apex, are left sided and associated with suppurative thyroiditis3, they manifest at a younger age and treatment involves excision of tract with ipsilateral thyroid lobectomy.