Background/ objectives: Branchial arch anomalies form 20% of the con-genital head and neck lesions and differ in their management depending on the arch involved. As all these anomalies are managed surgically accurate surgical anatomy is essential as it should be tailored to the lesion involved like it being a cyst, sinus or a fistula.
Materials and methods: 11 cases of complete branchial fistula were excised by the combined approach. 6 were females and 5 males, with average age group of 9.09 years and 3 were left sided and 8 right sided. Classical transcervical approach with double incisions at the fistula and hyoid and transoral avulsion of fistula with tonsillectomy done under general anaesthesia in all cases.
Results: The average length of the fistula was 7.27 cms. The patients were followed up month-ly for six months and later 6 monthly for 2 years. No recurrence were seen on 6-94 months of fol-low-up with an average follow-up of 43 months.
Conclusion: Combined Trans cervical Transoral approach is the conventional procedure of choice for complete branchial fistulas. This ap-proach with no recurrence rates can be made scar less with meticulous tensionless dermal su-turing and best skin approximation.