Complete branchial fistula - Case report and review of the literature

Branchial anomalies, a result of aberrant embryonic development, are rarely seen in clinical practice. Lesions of the second branchial pouch commonly present as a neck lump or discharging sinus that may be complicated by infe ction. Clinical examination often reveals the lesion to be related to the j unction of the upper two thirds and the lower one third of the sternocleido mastoid muscle. Branchial fistulas often present as a discharging sinus in the neck with the fistula tract extending upward within the deep neck tissu e for a variable distance. A complete branchial fistula is one that has a d efined internal opening in the tonsillar area and an external opening at th e skin overlying the sternocleidomastoid muscle at the junction of the uppe r two thirds and the lower one third of the muscle. The incidence of such l esions is extremely rare. Surgical excision is the treatment of choice for branchial anomalies. We present the case of a patient who presented with a complete branchial fistula and discuss the clinical presentation and surgic al management of such lesions, with a review of the relevant literature.