Treatment of BCA
To effectively treat second, third and fourth cleft BCA, total surgical excision is recommended. [12-14] A strict differentiation between sinuses, cysts or fistulae is necessary to guarantee the optimal choice of surgical technique and approach. [14] Within the treatment of fistulae or draining sinuses, a cutaneous excision of the duct opening is recommended. In the situation of the existence of residual tracts leading to the tonsillar fossa, beside the clear indication of extirpation of the tract itself, the necessity of ipsilateral tonsillectomy to prevent recurrence, is discussed. [5, 15-18] Overall, BCA-recurrence is stated up to 4%. [19-21]