Left sinus pyriform fistula treated by minimally invasive approach: A case report

Abnormalities of the fourth branchial arch are less common than those of the second arch and usually present with inflammation of the left thyroid lobe. We report the case of a 10 years old girl who presented to our department with recurrent cervical cellulitis, and who was diagnosed, upon endoscopic exploration, with a left sinus pyriform fistula. The patient was treated using mini-invasive surgery by electrocoagulation, with good clinical outcome. Branchial arch malformations are rare congenital malformations. The diagnosis is mainly based on clinical examination, imaging and, endoscopic investigations. The conservative attitude may be the treatment of choice, especially if the cervical mass is not well individualized. •The fourth arch anomaly is very rare, and few reports are available in the literature•This congenital anomaly manifests as recurrent cervical abscesses or acute suppurative thyroiditis in most cases.•Recently, minimally invasive endoscopic surgery has revolutionized the management of the pyriform fossa sinus in children.