Bilateral III pouch branchial fistula

Abstract

An eight year old female was admitted via OPD with bilateral discharging sinuses. The ostium of the sinuses were at the anterior border of clavicular attachment of sternomastoid. There was H/O off and on whitish discharge, mucoid in consistency coming out from these external openings since last 6 years. It was not associated with any other complaint. There was no H/O respiratory infections, abscess formation, thyroiditis or swallowing difficulties associated with this. According to the location of external openings diagnosis of bilateral III pouch branchial fistula was made. Routine lab investigations showed normal profile. Fistulogram was attempted which was unsuccessful. Both the fistulous tracts were explored under general anaesthesia. The fistulous tract on left side was more developed as compared to the right. The left tract was extending upto the pyriform fossa and the right tract extended upto thyrohyoid membrane. Both tracts were completely excised. Postoperative recovery was uneventful. Clear liquids were permitted on the same day. Patient was discharged on second postoperative day and stitches were removed on fifth postoperative day. There were no complications on subsequent follow up for three months.