A previously healthy 9-year-old girl presented to the paediatric emergency department with a viral upper respiratory infection. The examination of the oral cavity revealed bilateral soft palate fistulas, about 5 mm in diameter (Fig. 1, black arrows). These defects were present since birth and caused no other problems than occasional obstruction with food during complementary feeding.

Figure 1.

Bilateral congenital fistulas in the lateral soft palate.

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Lateral soft palate fistulas are defects connecting the oral cavity and the pharyngeal area via the lateral aspects of the soft palate that are reported infrequently.1 They may be congenital, occasionally with a hereditary component, or more often acquired resulting from drainage of peritonsillar abscesses that may be primary or secondary to surgical complications.1–3

Congenital soft-palate fistulas are usually bilateral and benign, but they can be associated with other anatomic or functional anomalies in the development of the second branchial pouch (aplasia or hypoplasia of one or both palatine tonsils, preauricular fistulas, hearing loss and strabismus).1–3 In the case presented here, the patient had no relevant family history or other associated anomalies, and there were no complications during the follow-up.

There are numerous normal variants of soft tissue structures in the oral cavity that must be recognized clinically. In light of the absence of described cases in recent years, some authors have even brought up their disappearance from the literature.