case_images: PMC11786695_01
case_images: Pre-operative view of the opening of second branchial cleft fistula on the right half of neck as indicated by the arrows.
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case_images: PMC11786695_01_gr1.jpg
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case_images: A small, pinhole opening was seen along the anterior border of sternocleidomastoid at the junction of its upper 2/3rd and lower 1/3rd (Fig. 1).
case_images: A sinogram with water-soluble contrast revealing a complete second branchial cleft fistula extending from an outer opening on the anterior border of sternocleidomastoid to an inner opening in the tonsillar fossa.
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case_images: PMC11786695_01_gr2.jpg
case_images: f0010
case_images: The contrast was seen outlining a smooth linear tract through an external opening on the right, lateral aspect of neck ascending upwards with the passage of contrast, through the second opening in the posterior part of the right side of the floor of oral cavity (tonsillar fossa) (Fig. 2).
case_images: Methylene blue dye being injected to aid the presence of the location of the fistulous tract.
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case_images: PMC11786695_01_gr3.jpg
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case_images: For helping with the identification of the tract, methylene blue dye was instilled (Fig. 3).
case_images: Two incisions given in a stepladder manner for the excision of the tract.
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case_images: PMC11786695_01_gr4.jpg
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case_images: Two transverse elliptical incisions were made in a stepladder fashion (Fig. 4).
case_images: The completely excised fistula placed against a scalpel.
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case_images: PMC11786695_01_gr5.jpg
case_images: f0025
case_images: The tract was then completely excised through the upper incision (Fig. 5).