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Case report
Fourth branchial pouch anomaly presenting as a neonatal neck lump


A 1-week-old female infant presented with a transilluminating neck lump that increased in size with crying. The presumptive diagnosis was lymphatic malformation, but imaging raised the possibility of an abscess or necrotic tumour. A biopsy revealed a likely developmental cyst with local inflammatory change. Microlaryngoscopy revealed a fourth branchial pouch sinus, which was cauterised. The sinus and neck lump resolved without need for further treatment.

  • ear
  • nose and throat/otolaryngology
  • congenital disorders
  • head and neck surgery
  • otolaryngology / ENT

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