Endoscopic Cauterization of Fourth Branchial Cleft Sinus Tracts

Objective: To evaluate the effectiveness of endoscopic cauterization as definitive treatment for fourth branchial cleft sinuses. Design: Retrospective chart review with follow-up questionnaire. Setting: Tertiary care children's hospital. Patients: Ten children (age range, 10 months to 10 years) with fourth branchial cleft sinuses treated with endoscopic cauterization between 1995 and 2002. Main Outcome Measure: Recurrence of neck infections after endoscopic cauterization of fourth brachial cleft sinus tracts. Results: Seven of the 10 patients treated with endoscopic cauterization of the fourth branchial cleft sinuses showed no recurrence with an average follow-up of 3 years. Three of the patients were unavailable for follow-up, but medical records of the hospital showed no additional admissions for those patients for neck masses. No morbidity of the procedure was identified. All patients were discharged the day of surgery. Conclusions: Endoscopic cauterization of fourth branchial cleft sinuses appears to be an effective alternativc to open excision.