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Microbiology of third and fourth branchial pouch cysts
Author(s) -
Pahlavan Shane,
Haque Waqar,
Pereira Kevin,
Larrier Deidre,
Valdez Tulio A.
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20724
Subject(s) - pouch , medicine , pharyngeal pouch , surgery , abscess , thyroglossal duct , eikenella corrodens , retropharyngeal abscess , cyst , biology , bacteria , genetics
Objectives/Hypothesis: To identify the most common pathogens involved in infections of third and fourth branchial pouch cysts. Third and fourth branchial pouch cyst infections are an uncommon cause of anterior neck abscesses often confused with other entities, such as thyroglossal duct cysts and thyroid abscesses leading to misdiagnosis, recurrence, and increased morbidity related to a delay in diagnosis and appropriate treatment. Study Design: Retrospective chart and literature review. Methods: Retrospective chart review case series of patients presenting to the Bobby R. Alford Department of Otolaryngology at Texas Children's Hospital from July 2004 to July 2008 with third and fourth branchial pouch cysts. Results: A total of 11 patients were identified. All patients had left‐sided lesions. Eikenella corrodens was found in 60% of cultures and was the most common organism identified in our patient group. Furthermore, 56% of the organisms isolated were anaerobic. All organisms with the exception of Staphylococcus aureus were identified as oral cavity flora. Conclusions: Third and fourth branchial pouch cysts provide a communication between the neck and the oral cavity through pyriform sinus tracts. The presence of oral cavity flora in a left anterior neck abscess should raise the suspicion of a branchial pouch anomaly, and subsequently alter therapeutic management. Laryngoscope, 2010