Aberrant second branchial cleft fistula

Second branchial cleft cysts and sinuses rarely present diagnostic problems to the pediatric otolaryngologist as their course is usually predictable b ased on consistent embryologic development. However, we evaluated two fistu la tracts that did not fit the classic description of second branchial trac t fistulas. Upon radiographic and intraoperative evaluation, their eventual course ending in the tonsillar fossa was identified. Realizing the potenti al for aberrancy and using preoperative radiographic evaluation will assist the surgeon in the excision of these developmental anomalies with little r isk to underlying neurovascular structures. (C) 1998 Elsevier Science Irela nd Ltd. All rights reserved.