Lateral cervical fistulae which communicate with the oropharynx are co
nsidered to result from incomplete obliteration of the second branchia
l cleft and pouch. Classically these fistulae have a well-defined path
way through the neck. We present a case, and discuss the aetiology, of
a fistula extending from the lateral neck via a previously undescribe
d course through the neck structures and opening into the posterior as
pect of the tongue at the level of the vallate papillae.