title: The fourth branchial cleft anomaly.
abstract: The fourth branchial cleft anomaly has long been postulated. A case in which a lower neck sinus tract extended under the clavicle near the subclavian vessels is presented. The distinguishing features of bronchogenic and branchogenic anomalies are discussed. It appears that unless a complication (e.g., abscess, inflammatory process) of the fourth branchial cleft sinus tract occurs within the mediastinum, mandating full exploration, the complete form of the anomaly may continue to remain undocumented.
mesh_terms: D000293:Adolescent; D001935:Branchioma / Q000473:pathology*; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology; D005402:Fistula; D006258:Head and Neck Neoplasms / Q000473:pathology; D006801:Humans; D008297:Male