A case of congenital complete second branchial fistula

Congenital lateral cervical fistula is a branchial anomaly that is formed by the abnormal evolution of the branchial cleft. Most lateral cervical fistulas lack an internal opening and the occurrence of complete lateral cervical fistula with an external and internal opening is rare. We report a case with a left complete lateral cervical fistula from the second cleft. A 3-year-old boy complained of mucal discharge from an opening in the left lower neck. A duct was identified by image examination （CT, MRI）, which was present along the anterior margin of the sternocleidomastoid muscle, and extended further upward from the common carotid artery bifurcation, gradually becoming thinner. The duct was completely extirpated under general anesthesia. In the surgery, two horizontal incisions were made in the neck, and 4-0 Nylon was used as a guide. An internal opening was found at the low pole of the tonsil. These findings suggested that the complete lateral cervical fistula was derived from the second branchial cleft. Three years after surgery, obvious recurrence has not been observed.