Year: 2017 | Month: June | Volume: 7 | Issue: 6 | Pages: 358-361
Bilateral Branchial Sinus: A Case Study
Dr. Pooja Sharma1, Dr. Sanjay Marwah2, Dr. Nityasha3, Dr. Amit Garg1, Dr. Vikram Pal Singh1
1Postgraduate Student, 2Senior Professor, 3Professor,
Department of General Surgery, Pt. B.D. Sharma PGIMS, Rohtak-124001, Haryana (India)
Corresponding Author: Dr. Pooja Sharma
Background: Development of head and neck during fetal life occurs by means of the branchial apparatus which appears during the 4th and 5th week of intra-uterine life. The branchial arches usually involute by the 7th week of intra-uterine life. Failure of the branchial apparatus to involute may lead to various developmental anomalies such as branchial cyst, sinus and fistulas. Material and Methods: A 21-year-old girl presented with a history of discharge from right and left sides of lower part of her neck since birth. The patient had bilateral neck swelling over the same site at the time of birth, which burst open spontaneously later in life followed by discharge from the swelling which is sometimes whitish viscous, non foul smelling, painless and sometimes bloody. Results: The patient was planned to undergo exploration and excision of the fistula. Excision of both sinus tract was done which turned out to be fistulaous tract. Dissection was done with stepladder pattern incision. Fistula was cut and ligated at the upper end of dissection, probing was done with a guide wire. Wound was closed with vicryl 3-0 and skin closed with stapler. The post-operative period was uneventful and the patient recovered completely. Conclusion: A histopathological examination of the specimen confirmed the presence of a tract lined by pseudostratified columnar epithelium with abundant subepithelial lymphoid tissue.
Key words: Bilateral branchial sinus, branchial apparatus, branchial, fistula.