title: Transoral robotic surgery-assisted excision of a congenital cervical salivary duct fistula presenting as a branchial cleft fistula.
abstract: BACKGROUND
  Congenital cervical salivary duct fistulae are rare entities and can mimic branchial cleft fistulae. Ectopic salivary tissue associated with these pharyngocervical tracts may have malignant potential.
  
  
  RESULTS
  We present a case report of a novel surgical approach and review of the literature. A 27-year-old man presented with complaint of drainage from the right side of his neck since early childhood. A tract was found from the posterior tonsillar pillar into the neck and ectopic salivary tissue was found along the tract. A congenital hearing loss was also present. Transoral robotic (TORS)-assisted surgery was used in the management of this patient and allowed excellent visualization of the pharyngeal component of the lesion and a minimally invasive approach. The patient did well with no recurrence.
  
  
  CONCLUSIONS
  TORS was helpful for management of a congenital salivary fistula and may be helpful for branchial cleft fistulae. These lesions may be associated with the branchio-oto-renal (BOR) syndrome.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Rassekh
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Ken
authors.identifier: http://orcid.org/0000-0001-8346-9151
authors.initials: K
authors.lastname: Kazahaya
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Livolsi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.|Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Loevner
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Andy T
authors.initials: AT
authors.lastname: Cowan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Weinstein
mesh_terms: D000328:Adult; D001934:Branchial Region / Q000002:abnormalities; D003937:Diagnosis, Differential; D005402:Fistula / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D065287:Robotic Surgical Procedures / Q000379:methods*; D018987:Salivary Ducts / Q000601:surgery*; D012466:Salivary Gland Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*
keywords: branchial cleft; cervical; congenital salivary; pharyngeal; transoral robotic surgery