Branchial Cleft Sinus Tract VS Fistula?

Methylene blue and lacrimal probes assist in the dissection.  Over probing can lead to cyst wall penetration and over dissection.  Often the surgeon needs to combine direct larygoscopy with the external approach to identify the origin of the fistula.  Cauterization of the mucosa at the origin has proven acceptable vs some type of a stitch closure.