Endoscopically assisted branchial fistula excision

We describe an endoscopically assisted dissection technique for cervical branchial fistulae that prevents the need for additional 'ladder' incisions in the neck. Two titanium clips are placed at the internal opening of the tract under endoscopic guidance through the initial skin incision. This technique is a useful adjunct to the usual technique if difficulties are experienced obtaining access higher in the neck. It enables an excellent view of surrounding structures.