The professional name for ‘auricular hamartoma’ is congenital preauricular fistula is a common autosomal dominant disorder that is usually not combined with other ear malformations. The opening of the canal is mostly located in front of the foot of the pinna, but in a few cases it opens on the line between the interpeduncular notch and the corner of the mouth, or elsewhere in the earlobe. It is a narrow, curved, blind canal that may have branches. Individuals may reach as deep as the tympanic groove or posteriorly to the mastoid surface. The lining of the fistula is skin and may have hair follicles, sweat glands, and sebaceous glands, so the lumen may be lined with scales and broken hairs. Patients with congenital preauricular fistulas are often asymptomatic, but localized redness, swelling, pain, and pus may occur in cases of infection. Repeated infections can lead to localized abscesses, fistulas, scarring or cysts in the preauricular area, and in a few patients, the infection can extend into the external auditory canal or mastoid area and lead to a postauricular abscess, which can be easily misdiagnosed as mastoiditis. Congenital preauricular fistulas do not require treatment if they are asymptomatic. When the fistula is infected and forms an abscess, it should be incised and drained, and surgical removal is not possible until the acute inflammation is controlled. During surgical treatment, it is important to remove the fistula tissue and the scar completely at one time; if a few epithelial cells remain in the wall, the epithelial tissue will continue to grow, causing the infection to recur and making reoperation difficult. In the few cases where the postoperative wound is too large to be sutured, a skin graft may be considered. It should be noted that when a fistula opens in the external auditory canal or behind the submandibular angle, it is often the first gill sulcus fistula and must be treated with care because it is closely related to the facial nerve and improper treatment may cause facial paralysis.