Endoscopic management of fourth branchial arch anomaly: A case report

Fourth branchial cleft anomaly is a rare condition usually presented as recurrent neck abscess and suppurative thyroiditis. A variety of treatment options were reported in the literature. Here we present a case of a 15 year old female with left sided fourth branchial cleft anomaly. She was unsuccessfully managed by frequent surgical procedures with 6 incidences of recurrence in 2 years before applying the proper management described in this paper.This paper reports a rare case of fourth branchial cleft anomaly with description of presentation and diagnosis and demonstration of the effectiveness of endoscopic management with a long follow up duration (23 months) with no evidence of recurrence.This case shows that endoscopic cauterization of the fourth branchial cleft sinus can be considered as a less invasive effective alternative procedure to open excision.