First branchial arch anomaly: A rare lesion not to be underestimated

The authors report a case of Type I branchial fistula, a relatively rare lesion which requires a careful management from the diagnosis to the final surgical excision. In fact, the most frequent scenario implies one or more surgical drainages with recurrences before the proper diagnostic workout, based on an accurate examination and a RMN study. Surgical excision must take into account the risk of facial nerve injury and nowadays the standard of care recommends a magnification view and the facial nerve monitoring.