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      Quiste de la cuarta hendidura branquial. Caso clínico y revisión de la literatura Translated title: Fourth branchial cleft cyst. Case report and bibliographic review

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          Abstract

          RESUMEN Las anomalías del cuarto arco branquial son extremadamente infrecuentes y habitualmente se presentan como tumoraciones cervicales asintomáticas o infecciones recurrentes del cuello. El diagnóstico se establece mediante la realización de una adecuada anamnesis y exploración física, así como con pruebas de imagen complementarias. La exéresis quirúrgica completa constituye el gold standard de tratamiento. Presentamos el caso de una neonata con un quiste de la cuarta hendidura branquial que comenzó como una masa laterocervical izquierda asintomática, que fue diagnosticado mediante ecografía y resonancia magnética nuclear y tratado quirúrgicamente de manera precoz.

          Translated abstract

          ABSTRACT Fourth branchial cleft anomalies are extremely rare and usually present as asymptomatic cervical masses or recurrent neck infections. Diagnosis is made with an adequate anamnesis, physical examination and imaging tests. Complete surgical resection of the mass is the gold standard treatment to minimize the chance of recurrence. We report a case of a newborn with a fourth branchial cleft cyst presented as an asymptomatic left-sided neck mass. Diagnosis was made with ultrasonography and mangnetic resonance imaging and confirmed histologically after the patient was surgically treated.

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          Most cited references10

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          Management of congenital fourth branchial arch anomalies: a review and analysis of published cases.

          Congenital fourth branchial arch anomalies are uncommon entities, heretofore described only in case reports, affecting primarily children, and typically presenting as a cervical inflammatory process. The aim of the study was to collect appropriate data on the diagnosis, treatment, and outcome of this condition and to suggest guidelines for its management. We conducted a structured review of the literature for cases explicitly identified as congenital fourth branchial arch anomalies or meeting anatomical criteria for this condition. We computed descriptive statistics and performed several post hoc 2-way comparisons of subgroups of cases. We located and critically evaluated 526 cases. Fourth arch anomalies were usually located on the left (94%) and generally presented as acute suppurative thyroiditis (45%) or recurrent neck abscess (42%). Barium swallow and direct laryngoscopy were the most useful diagnostic tools. Treatment options differed mainly in recurrence rates: incision and drainage, 89%; open neck surgery and tract excision, 15%; endoscopic cauterization of the sinus tract opening, 15%; and open neck surgery with partial thyroidectomy, 8%. Complications after surgery occurred primarily in children 8 years or younger. Fourth arch anomalies are more common than once thought. Treatment of these disorders with repeated incision and drainage yields high rates of recurrence; thus, complete excision of the entire fistula tract during a quiescent period appears preferable. Combining this surgery with partial thyroidectomy may further decrease recurrence rates. Complications can likely be minimized by using antibiotic treatment of acute infections or endoscopic cauterization in children 8 years or younger, and delaying open neck surgery.
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            Branchial cleft and arch anomalies in children.

            Branchial anomalies are important lesions to consider in the differential diagnosis of head and neck masses in children. These anomalies are composed of a heterogeneous group of congenital malformations that arise from incomplete obliteration of pharyngeal clefts and pouches during embryogenesis. Although present at birth, many abnormalities do not become evident until later in infancy or childhood. It is common for branchial anomalies to become infected, causing significant morbidity. Surgical removal may be difficult, and inadequate resection of the lesion is likely to cause recurrence. Understanding the embryology and anatomy of these lesions is essential to the provision of adequate therapy.
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              Neck infection associated with pyriform sinus fistula: imaging findings.

              Acute suppurative neck infections associated with branchial fistulas are frequently recurrent. In this study, we describe the imaging findings of acute suppurative infection of the neck caused by a third or fourth branchial fistula (pyriform sinus fistula).
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                September 2021
                : 43
                : 3
                : 105-108
                Affiliations
                [1] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Cirugía Oral y Maxilofacial España
                Article
                S1130-05582021000300105 S1130-0558(21)04300300105
                10.20986/recom.2021.1163/2020
                9b644d4d-3673-4d31-b188-5a1dc42d03a5

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 29 October 2020
                : 11 May 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 4
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                branchial cleft anomaly,diagnóstico diferencial,neonato,malformación branquial,Cuarto arco branquial,differential diagnosis,neonate,Fourth branchial arch

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