During excision of a discharging second branchial fistula, the surgeon traces the tract upward. Where does the internal opening of a second branchial fistula lie?
- A Floor of the external auditory canal
- B Lateral wall of the nasopharynx
- C Tonsillar fossa in the oropharynx ✓
- D Pyriform fossa
Correct answer: C. Tonsillar fossa in the oropharynx
Explanation
A second branchial fistula runs from the skin at the lower third of the anterior border of sternocleidomastoid, passes between the internal and external carotid arteries, and opens internally in the tonsillar fossa, reflecting its origin from the second branchial cleft. A pyriform fossa opening indicates a third or fourth branchial anomaly, while the external auditory canal relates to first cleft anomalies, killing both key distractors.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.