Branchial Fistula

6 years old boy came with

C/o

Discharge from both sides of neck - 4 years

O/e
Small opening seen along the anterior border of upper 1/3 of sternomastoid muscle.

Mucoid discharge could be seen extruding through this opening

Surgical exploration was done under general anesthesia:

branch_1.jpg

Fistula being assessed by threading with proline

branch_2.jpg

The fistulous tract was completely excised

Discussion:

This is one of the most common Branchial anamolies. This anamoly is associated with
the second branchial arch. The fistulous tract invariably opens at the anterior border
of sternomastoid muscle, traverses between the carotid artery and vein to reach the
palatine tonsil. The internal opening may be present at the level of palatine tonsil.

Treatment:

Is via surgical excision of the fistula along with its tract.

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