Pyriform sinus malformations represent rare
third and fourth branchial anomalies. Fistulae at the latter
site were initially described and make up less than 1 % of
all brachial anomalies. They may be discovered inciden-
tally, or may present as a neck mass with recurrent infec-
tion, dysphagia, or airway compromise, and can be an
unusual cause of dysphonia in infant and children. Here,
we present a case of third branchial cyst located in pha-
ryngeal wall of the left pyriform sinus which presented
with dysphonia since birth in a 6-year-old girl. Transoral
CO 2 laser excision was carried out successfully with no
communicating tract. The patient’s dysphonia showed
progressive regression at 1-year follow-up. Third branchial
cyst in the left pyriform sinus (Bailey’s type IV) is an
unusual cause of dysphonia in pediatric. Our present case
pyriform fossa and the second branchial anomalies to be
excised transorally with CO 2 laser.report is the first brachial cyst to be reported in the