Endoscopic Management of Recurrent Third Branchial Fistula using Histoacryl Glue

M Z Naveed,A Naveed,A Irfanullah

doi:10.21699/ajcr.v9i1.650

Abstract

Third branchial cleft anomalies are rare accounting for 2-8% of all branchial abnormalities. We report a case of a 9 year old boy who presented with discharging sinus on the left side of neck. A sinogram revealed third branchial arch fistula. The tract was surgically removed, however, on follow up the fistula was recurred. He was later taken for endoscopic cauterization and injection of Histoacryl (n-Butyl cyanoacrylate ) glue into the tract, after which his wound healed swiftly. Historically, surgical excision of the fistulous tract has been the mainstay of treatment. Recently, minimally invasive methods are gaining wider acclaim and may potentially become the treatment of choice in the future.

Highlights

Branchial cleft fistula occur as a result of abnormal embryonic development of the branchial apparatus resulting in congenital anomalies of the head and neck.[1]
We describe the case of a 9 year old boy who presented with a third branchial cleft fistula, successfully treated endoscopically by electrocauterization followed by injection of the synthetic glue Histoacryl into the fistula tract
Diagnosis can be established by computed tomography, magnetic resonance imaging, sinogram, barium swallow or direct laryngoscopy

Summary

Introduction

Branchial cleft fistula occur as a result of abnormal embryonic development of the branchial apparatus resulting in congenital anomalies of the head and neck.[1]. A more minimally invasive approach of cauterizing the fistula tract using a variety of methods, is gaining wider acceptance especially in younger patients and those with previous recurrences after surgery.

Results

Conclusion