A new fistulectomy method for the second pharyngeal arch remnants.

PURPOSE We present a new fistulectomy method for the second pharyngeal arch remnants. MATERIALS AND METHODS Between 1991 and 2003, 4 patients have been treated with a new fistulectomy method. SURGICAL PROCEDURE Under general anesthesia with nasotracheal intubation, the neck and mouth are prepared as one operative field. A nylon thread is inserted into the cervical opening. On the oral site of the nylon thread, a small gauze ball is tied and gently pulled from the neck site. At both opening sites of the fistula, a very small incision around the nylon thread is performed. Using the nylon thread as a guide, a fistulectomy is carried out. RESULTS In all 4 patients, no complications have occurred during and after the fistulectomy. No recurrences were seen during 15 months to 9 years. CONCLUSIONS This is a simple and useful procedure for the treatment of second pharyngeal arch remnants. It produces an excellent cosmetic result compared with the standard method because only one small incision is necessary.