We describe a case of a 55-year-old man who presented with sore throat for two days, while neck swelling for one day, and was found to have a fistula in his left tonsil and an abscess in his left lateral pharyngeal wall with the lower bound to the upper border of the cricoid cartilage by ultrasonography and enhanced CT. The fistula from tonsillar fossa to hypopharynx was detected followed by left tonsillectomy, and then anterior wall of the fistula and mucosa covering it was resected. He was eventually diagnosed with incomplete second branchial fistula with infection, and was followed up for five years with no recurrence.
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