Histoacryl injection in the management of fourth branchial fistula

Abstract

Purpose The aim of this study is to evaluate a minimal invasive approach in the management of fourth branchial fistula using N-butyl cyanocrylate (histoacryl) and to study its feasibility.
Patients and methods Between 2006 and 2011, a retrospective study of five children with fourth branchial fistula treated at Assiut University hospital was carried out. Their age ranged from 2 to 5.5 years. Three were females. Histoacryl (adhesive material) was injected through the tract under general anesthesia.
Results All the children presented with a discharging fourth branchial fistula. Three of them had a left-sided fistula. Fistulogram was carried out in all patients; two of them had a complete fistula. The duration of the procedure ranged between 10 and 15 min. No complications were noted. The duration of follow-up ranged from 2 months to 1 year. No recurrence was encountered during the period of follow-up.
Conclusion Histoacryl injection of the fourth branchial fistula is an effective, easy, and minimally invasive procedure that can be carried out by junior staff. Surgery may be performed as a backup if there is failure or recurrence after injection.

Keywords: branchial fistula, children, fourth branchial fistula, histoacryl