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3 results on '"Recurrent neck abscess"'

1. A Case of Rare Fourth Branchial Arch Anomaly: Presentation and Surgical Management.

Author

Qin Y and Ling S

Abstract

This report presents a case of a six-year-old male patient with recurrent left-sided neck abscesses who presented four times over a span of two years. At each presentation, the child had developed left-sided neck swelling, pain, and fevers that required hospital admission. In the patient's most recent admission in 2020, a fourth branchial cleft anomaly was confirmed on CT, and the patient was taken to the operation theatre for ultrasound-guided aspiration and cauterisation of the sinus fistula tract under direct pharyngoscopy. This allowed for definitive management of the area and, to date, has prevented any recurrence. Although fourth branchial anomalies are rare within overall branchial arch pathologies, this case highlights the importance of considering this to be a differential diagnosis in a patient presenting with recurrent neck abscesses, particularly in children., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Qin et al.) more...

Published
2024
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2. Fourth branchial anomalies: Predictive factors of therapeutic success

Author

Michel Mondain, Mohamed Akkari, Jean-Michel Triglia, Richard Nicollas, Eric Moreddu, Nicolas Leboulanger, Marie-Eva Rossi, Françoise Denoyelle, ORL et Chirurgie cervico-faciale pédiatrique - [Hôpitaux Timone et Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service ORL [Hôpital Gui de Chauliac] (CHRU de Montpellier), Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'ORL, Hôpital Gui de Chauliac (CHRU de Montpellier), Service d'ORL pédiatrique et Chirurgie Cervico-faciale [CHU Trousseau], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU) more...

Subjects
Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], Recurrent nerve, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, 030225 pediatrics, Epidemiology, Humans, Medicine, Fourth branchial pouch, Endoscopic cauterization, Child, Open-neck surgery, Abscess, Retrospective Studies, Congenital malformations, Palsy, business.industry, Open surgery, Infant, Newborn, Infant, Endoscopy, General Medicine, medicine.disease, Recurrent neck abscess, 3. Good health, Surgery, Risk-factors, First line treatment, Branchial anomaly, Branchial Region, Dyspnea, Treatment Outcome, Child, Preschool, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Female, business, Neck
Abstract

Purpose The purpose of this work was to determine the epidemiology and the predictive factors of success of the surgical management of fourth branchial anomalies. Methods This is a multicentric retrospective review from 1998 to 2016 of patients who presented with an endoscopically-confirmed fourth branchial pouch anomaly. Data were analyzed according to sex, age, clinical features, number of recurrences, treatment modalities (endoscopic and/or cervicotomy), post-operative complications and follow-up. Results Fifty-two children have been included. The average age at diagnosis was 4.5 years. Among them, 73.1% were female, 11.4% were neonatal forms; 94.2% of lesions were left-sided; 75% of patients presented a cervical abscess as first symptom, and 7.7% of children presented with dyspnea. Average time between first symptoms and management was 9.5 months. Management was endoscopic in 73.1% of patients (laser in 84.2%, coagulation in 15.8%) with about a third of recurrence after one procedure. Overall success of endoscopic procedures reached 84.2%. A cervical open surgery was performed in 26.9% as first line treatment. Overall success of cervicotomy reached 85.7%. No complications of endoscopic surgery have been identified. There were 35.7% complications of cervicotomy (2 recurrent nerve palsy, 2 keloid scars, 1 pharyngostoma). An association was proved between recurrences and initial abscess (OR = 2.44), and with age between 3 and 5 (OR = 4). Conclusion Endoscopic treatments appear to be effective in first line approach in the management of fourth branchial anomalies, offering an excellent efficiency with rare complications. We identified two risk factors of recurrence: age between 3 and 5 years old and history of cervical abscesses. Level of evidence IV. more...

Published
2019
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