Microbiology of third and fourth branchial pouch cysts.

Shane Pahlavan, Waqar M. Haque, Kevin Pereira, Deidre Larrier, Tulio A. Valdez

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)458-462
Number of pages5
JournalThe Laryngoscope
Issue number3
StatePublished - Mar 2010

ASJC Scopus subject areas

  • Otorhinolaryngology


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