Recurrent thyroid abscess — Is it a fourth branchial archanomaly?

Branchial fistulae are of congenital origin⁶ and consists of skin lined tract opening internally at junction of cartilaginous and bony meatus in case of 1^st arch anomaly, tonsillar fossa in case of 2^nd arch, while 3^rd and 4^th arch sinuses have internal opening at level of pyriform sinus or below. A complete tract of 3^rd or 4^th arch fistulae is yet to be described. Fourth arch fistulae¹ have a distinct clinical pattern of internal opening at pyriform apex, are left sided and associated with suppurative thyroiditis³, they manifest at a younger age and treatment involves excision of tract with ipsilateral thyroid lobectomy.