Abstract:ObjectiveTo analyze the clinical manifestations of and surgical techniques for variant preauricular fistula.MethodsMedical records of 320 patients underwent preauricular fistulectomy in our hospital from Jan 2000 to May 2014 were reviewed. Of them, 12 cases were diagnosed as variant preauricular fistula. Their clinical data including clinical manifestations, family histories, previous surgical histories and procedures, and recurrence rates were analyzed retrospectively.ResultsTwelve (3.75%) of 320 patients were diagnosed with the variant preauricular fistula. All the cases had history of fistula infection. The locations of fistula orifices were in the cavum conchae or cymba conchae (4 ears), ascending helix crus and postauricular area (4 ears), postauricular area (1 ear), ascending helix crus and external auditory canal (2 ears), external auditory canal and postauricular area (1 ear). The surgical incisions were healed primarily in 11 cases (91.7%, 11/12). In the case with poor wound healing after operation, nanoparticulate silver gel was used to cover the defects and the wound got healed secondarily. All the 12 patients had been followed up for at least 6 months postoperatively, and recurrence occurred in none with a recurrence rate of 0%.ConclusionA comprehensive physical examination of the preauricular pits should be performed to avoid missed diagnosis of variant preauricular fistula. Detailed surgical techniques should be performed, and operating microscope and innovative dressings with antibiotic action may facilitate to remove remnants and prevent recurrence.
