Presentation
Visible right anteroinferior cervical sinus and ongoing drainage. The sinus was first identified at 2 months of age.
Patient Data
The fistulogram performed under fluoroscopy reveals a superior coursing, linear, fistulous tract towards the right pyriform sinus most likely.
Limited ultrasound confirmed the sinus anterior to the right sternocleidomastoid muscle and right thyroid lobe. There is a fistulous tract coursing superiorly towards the oropharynx.
There is no thyroid or sternocleidomastoid abscess or collection.
Case Discussion
This is a companion case to rID 148972.
Features consistent with a fourth branchial cleft anomaly, specifically a fourth branchial fistula extending inferiorly from the apex of the right pyriform sinus to the right suprathyroid cutaneous opening anterior to the right sternocleidomastoid muscle well demonstrated by the fistulogram.