Complete 2nd arch branchial fistulae are very rare congenital anomalies of head and neck. They arise due to the incomplete obliteration of the branchial clefts during embryonic period. In this article we report a case of type IV 2nd branchial cleft anomaly in a 15-year-old female. Explicit knowledge regarding its development, anatomy and accurate diagnosis, skillful complete excision of the tract is paramount in its management and to prevent recurrence.
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