Recurrent Suppurative Thyroiditis Research Articles

Cervical infection secondary to pyriform sinus fistula of branchial origin

Complete third branchial arch anomalies are rare and have been described only in case reports, affecting mainly children and typically presenting as a cervical inflammatory process. Anomalies of the third and fourth branchial apparatus, though rare, usually present as sinuses/incomplete fistulas of pyriform sinus or recurrent suppurative thyroiditis. A 6-year-old girl presented with a small opening on the left side of her anterior neck, which had been present since birth and was associated with recurrent infection. She had no history of incision and drainage of swelling. Computed tomography with contrast injection into the cervical opening revealed a fistulous tract extending from the cervical neck skin to the pyriform fossa. Complete excision of the fistulous tract and left hemithyroidectomy were performed. There was no recurrence at 22 months of follow-up.

Thyroid abscess with branchial anomaly

The third arch branchial fistula is a rare congenital abnormality that presents as an inflammatory process in the anterior neck, often in the region of the left lobe of thyroid. Incomplete fistula is not an uncommon finding extending from base of pyriform sinus to the thyroid or perithyroidal space, which predisposes to recurrent suppurative thyroiditis during episodes of upper respiratory infection. Complete fistula of third arch is extremely uncommon, especially of congenital origin. A 10-year-old male child presented with a small opening in the anterior neck since birth, with a swelling around it. Computerized tomography revealed a patent tract from neck skin to base of pyriform sinus. Total excision of the tract up to the left pyriform sinus with hemithyroidectomy was performed. There was no recurrence at 22 months of follow-up.

Bilateral Pyriform Sinus Fistulas Presenting as Recurrent Suppurative Thyroiditis

Bilateral Pyriform Sinus Fistulas Presenting as Recurrent Suppurative Thyroiditis

Fourth Branchial Cyst Presenting with Right-Sided Vocal Cord Paralysis

Fourth branchial anomalies are rare entities. Despite this, they must be considered when presented with a low lateral neck mass, recurrent lower neck abscesses, or recurrent suppurative thyroiditis. The truly unique presentation of this case highlights the importance of including these anomalies in the differential diagnosis for all neck lesions.

P121: Bilateral Fourth Branchial Cleft Cyst Presenting as Recurrent Suppurative Thyroiditis

P121: Bilateral Fourth Branchial Cleft Cyst Presenting as Recurrent Suppurative Thyroiditis

Bilateral fourth branchial cleft cyst presenting as recurrent suppurative thyroiditis

Bilateral fourth branchial cleft cyst presenting as recurrent suppurative thyroiditis

Recurrent suppurative thyroiditis due to pyriform sinus fistula: a case report

Recurrent suppurative thyroiditis due to pyriform sinus fistula: a case report

Persistent third branchial apparatus

Neck sinuses, cysts or fistulae arising from the third branchial apparatus, have seldom been reported. Between 1979 and 1989, 16 cases were diagnosed as persistent third branchial apparatus based on a fistula open or in proximity to the pyriform sinus. There were 8 boys and 8 girls whose ages ranged from newborn to 13 years. Esophagogram was performed in 6; 4 showed a fistula tract leading to the pyriform sinus. Others were demonstrated at surgery. The main presentations were suppurative thyroiditis (5), lateral neck fistula (5), cyst (3), mass (1), abscess (1), and esophageal stricture (1). This was interpreted as a spectrum of disease that in the newborn may present as a cyst, and later in childhood as a fistula in the lower neck or recurrent suppurative thyroiditis if the fistula ends in the thyroid gland. It is imperative to search for this internal communication to the pyriform sinus to make a correct diagnosis and to avoid development of esophagocutaneous fistula postoperatively. With more awareness of this disease entity, the noted incidence should increase.

Recurrent suppurative thyroiditis due to pyriform fossa—thyroid fistula

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Acute recurrent suppurative thyroiditis in childhood: Y. Zarfin, E. Theodore and T. S. Zwas. Harefuah 100:153, (February), 1981

Acute recurrent suppurative thyroiditis in childhood: Y. Zarfin, E. Theodore and T. S. Zwas. Harefuah 100:153, (February), 1981