bilateral second arch branchial fistula-a case report

Introduction: branchial arch anomalies represent defects in embryological developments whereby parts of the branchial arch persist in the head and neck regions as sinuses, fistulas, or cysts. these anomalies usually present as a unilateral lesion in the head and neck of young adults and children, which are excised upon the emergence of complications.   case report: herein, we presented a rare case of a 4-year-old child, who had been diagnosed with a complete bilateral second arch branchial fistula. the excision was made using the bilateral stepladder approach and tonsillectomy.   conclusion: the bilateral stepladder approach was a feasible method in excising a complete bilateral branchial fistula. however, larger-scale studies should be conducted on the surgical techniques of bilateral branchial fistulae excision in order to optimize the cosmetic outcome of the surgery.