Selective Neck Dissection Technique in the Treatment of Recurrent Pyriform Sinus Fistula

The 3rd and 4th branchial arch fistulas are rare conditions which are due to embryological persistence or incomplete developmental anomalies. They have a typical course as described by the embryological development but the presentation of cases with true course as per embryology is rare. These patients usually present with repeated infections, inadequate surgical interventions and recurrences. We present two index cases of 3rd and 4th pyriform sinus fistulas with their varied anatomical course and clinical presentation who were treated by selective neck dissection technique.