A, Contrast-enhanced axial CT scan at the level of the thyroid gland shows a small air pocket within the left lobe of the thyroid gland (black arrow), which is thought to be characteristic of a branchial sinus remnant. A, Contrast-enhanced axial CT scan at the level of the thyroid gland shows a small air pocket within the left lobe of the thyroid gland (black arrow), which is thought to be characteristic of a branchial sinus remnant. B, Pharyngoscopy photograph shows the opening (white arrow) of the branchial pouch sinus in the apex of the pyriform fossa. B. Thomas et al. AJNR Am J Neuroradiol 2010;31:755-760 ©2010 by American Society of Neuroradiology