Pull-through branchial fistulectomy: a technique for the otolaryngologist.

The complete second branchial fistula consists of a superficial infrahyoid portion and a deep parapharyngeal portion. Through the present technique, the infrahyoid portion is dissected from the neck while the parapharyngeal segment is dissected through the mouth with or without tonsillectomy. Eventually, the whole fistula is pulled out through the mouth. This technique ensures complete fistulectomy and a low recurrence rate, is more cosmetic than the traditional technique, and allows simultaneous tonsillectomy. It may not be satisfactory if the fistula was the seat of repeated infections. This technique is suitable for the otolaryngologist, who is naturally well acquainted with microsurgery and tonsillectomy.