Surgical managements which form the mainstay of these branchial apparatus anomalies are based on accurate understanding of the embryology and surgical anatomy. The conspicuous scarring in the young which becomes conspicuous as the age advances are reduced by newer approaches, the facelift approach, retroauricular approach and endoscope-assisted neck approach.

A retrospective case series analysis of eight patients with complete fistula managed by the combined trans cervical approach. The recurrence was nil, with good surgical access and minimal scar at the incision site.

Combined transcervical approach is the conventional procedure of choice for branchial fistulas. While retroauricular hairline incision (RAHI) approach and endo-scopic approaches need expertise and more instrumentation, meticulous cosmetic surgery techniques helps reduces scars of the transcervical approach.

Bhat RS, Naik SM, Goutham MK, Bhat S, Appaji M, Chidananda KV, Devi NP, Joseph S, Nayak P. Branchial Fistulas—A Rare Entity in Pediatric Otorhinolaryngology: Current Management Protocols and Review of Literature. Int J Head Neck Surg 2014;5(3):108-111.