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Thyroidal abscesses in third and fourth branchial anomalies: not only a paediatric diagnosis
Author(s) -
Kruijff Schelto,
Sywak Mark S.,
Sidhu Stan B.,
Shun Albert,
Novakovic Daniel,
Lee James C.,
Delbridge Leigh W.
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12576
Subject(s) - medicine , abscess , thyroid , thyroiditis , presentation (obstetrics) , surgery , retrospective cohort study , thyroidectomy , incision and drainage , retropharyngeal abscess
Acute suppurative thyroiditis and recurrent abscess formation due to third and fourth branchial anomalies typically present in children. However, thyroid abscesses in branchial anomalies may occur in adulthood as well. Failure to recognize and delayed drainage of a neck abscess may lead to a fulminant life‐threatening outcome. Methods This is a retrospective case series. The study group comprised all patients presenting over a 12‐month period from J anuary to D ecember 2012 with thyroid abscesses and a branchial cleft anomaly in two centres, one adult and the other paediatric. Patient demographics, clinical presentation, imaging, surgical management, definitive histology and outcomes were documented. Results Five patients were identified with a history of thyroid abscesses. Only one was a child (aged 9 years) with the other four being adults (aged 20, 34, 37 and 41 years). All patients had third or fourth left branchial cleft anomalies, presenting as suppurative thyroiditis with a left‐sided thyroid abscess. Management options ranged from abscess drainage on initial presentation, primary thyroid lobectomy or delayed thyroid lobectomy following abscess drainage. Conclusion Acute suppurative thyroidits and thyroid abscesses is not just a paediatric diagnosis but may present at any age. In both children and adults, a thyroid abscess almost always arises from branchial cleft anomalies.