Nonsyndromic Complete Second Branchial Cleft Fistulas: A Clinicosurgical Experience

Branchial cleft anomalies are congenital malformations resulting from the abnormal persistence of branchial clefts during embryogenesis, often presenting as cysts, sinuses, or fistulae. These anomalies account for approximately 20% of pediatric head and neck masses, with bilateral cases being particularly rare. This report discusses a case of an 11-year-old boy with complete bilateral second branchial cleft fistulae, characterized by intermittent mucopurulent discharge and recurrent inflammation, primarily following upper respiratory infections. Diagnostic imaging, including CT scans, confirmed the presence of bilateral fistulous tracts. Surgical management involved a combined transoral and transcervical approach, including bilateral tonsillectomy and complete excision of the fistulous tracts. The procedure resulted in successful removal of the anomalies without postoperative complications. This case emphasizes the importance of thorough diagnostic evaluation and the effectiveness of complete surgical excision in managing bilateral branchial cleft anomalies to prevent recurrence and improve patient outcomes. Further research is warranted to optimize surgical techniques and postoperative results.