Fourth Branchial Pouch Sinus 1 Case / 대한이비인후과학회지

ABSTRACT

A fourth branchial pouch sinus is very rare disease with less than 35 cases reported in the literature since they were first described by Tucker and Skolnick in 1972. It is a congenital anomaly that begins in the apex of the piriform sinus, and exits the pharynx inferior to the fourth arch derived from the superior laryngeal nerve, cricopharyngeus, and thyroid cartilage, and descends in the neck lateral to the trachea and esophagus. It is most frequently manifested by recurrent episodes of neck abscess or acute suppurative thyroiditis. This lesion usually becomes symptomatic before the age of 10 years and is found in the left sides in 93%. Proper diagnosis and appropriate surgical management depend on thorough understanding of embryology and anatomy, and keen suspicion. We report of a case of fourth branchial pouch sinus in a 12-year old male, who was treated with thyroid lobectomy, excision of sinus tract, and laser ablation of interanl opening.