MRI
Bilateral fourth branchial cleft fistulae and right branchial cleft cyst. The fistulae originate at the apex of the piriform fossae bilaterally and descend to the base of the neck. The right fistula terminates into tiny palpable right branchial cleft cyst and the left terminates with visible cutaneous opening anterior to the sternocleidomastoid muscle and thyroid gland.
The fistulae extend 45 mm craniocaudally and the right branchial cyst measures approximately 5 mm in diameter.
There is no abnormal post-contrast enhancement, excluding superadded sepsis/abscess formation.
Incidental uncomplicated sinusitis and reactive, benign-appearing, anterior cervical chain lymphadenopathy.