Abstract
BackgroundPharyngeal arch anomalies are the second most common form of head and neck congenital defect. The second arch anomalies are the most common, and compromise 95% of cases. Little is known about the 3rd and 4th arch anomalies as they are extremely rare. They most commonly present in childhood with sudden severe left lateral neck infection and abscess formation with considerable tendency to recur, contributing to significant mortality and morbidity in those patients.Case presentationHere we present four cases finally diagnosed as third or fourth pharyngeal arch anomalies, with more than 20 years of follow-up following their definitive surgery. The possibility that they are thymopharyngeal duct remnants is discussed.ConclusionMeticulous open radical surgical excision of all involved paralaryngeal, parapharyngeal and thyroid tissue, with preservation of the superior and recurrent laryngeal nerves, is required for cure of recurrent cases.Graphical abstract
Highlights
Clinical aspects Pharyngeal arch anomalies are the second most common form of head and neck congenital defect
Three cases had become initially symptomatic in childhood and all of them presented as acute left sided neck infections, without signs of a sinus or fistula
Fistulas only developed after spontaneous rupture of the neck abscess and incision and drainage procedures
Summary
Clinical aspects Pharyngeal arch anomalies are the second most common form of head and neck congenital defect. The 3rd and 4th arch anomalies described in the medical and surgical literature are extremely rare They most commonly present with sudden severe lateral neck infection and abscess formation, which may involve the thyroid gland. They are more common in children but can present primarily in adults [1]. Little is known about the 3rd and 4th arch anomalies as they are extremely rare They most commonly present in childhood with sudden severe left lateral neck infection and abscess formation with considerable tendency to recur, contributing to significant mortality and morbidity in those patients. The possibility that they are thymopharyngeal duct remnants is discussed
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