Branchial cleft cyst to jugular vein fistula. An unusual complication.

Although fistulization between branchial cleft cysts and major vascular structures is extremely rare, it is a potentially serious complication, particularly with recurrent episodes of inflammation. Needle aspiration of a fluctuant lesion prior to formal incision and drainage is crucial. It confirms the nature of the lesion, thus avoiding potential complications. The importance of early exploration and excision of this type of fistula makes possible the early definitive treatment of branchial cleft cysts.