Recurrent laterocervical suppurations. Role of fistulae and cysts of the 4th branchial pouch

: Four cases of fistula of fourth branchial pouch are used as a basis for a description of the two possible clinical pictures: left cervical suppuration in a neonate with respiratory distress or recurrent cervical cellulitis in an older child or young adult usually diagnosed as a suppurative thyroiditis. Diagnostic features are outlined and emphasis placed on the need for an adapted surgical excision originating at the pharyngeal orifice of the fistula. In two of the four cases reported its trajectory was between muscle and mucosa planes and then in contact with the cricothyroid joint as a small cord, otherwise unidentifiable.