Thyroid abscess with branchial anomaly

Clinical photograph of third branchial fistula in which the external skin opening was noticed on the middle third of the anterior neck 1.5cm left of midline.

Computerized tomography following contrast injection externally reveals the collection of the material just beneath skin opening.

Computerized tomography showing the passage of contrast along the tract which passes through the left lobe of thyroid following external injection.

Computerized tomography revealing the spillage of the contrast into the pyriform sinus following injection through the external opening in neck.

Appearance of 1% methylene blue in the tract following its injection into the aperture of pyriform sinus under rigid endoscopic guidance, after left hemithyroidectomy in continuous with the tract, made the localization of the tract easier during dissection.

Specimen of the third branchial fistula excision up to pyriform sinus, coupled with left hemithyroidectomy.