Congenital preauricular fistula is a common congenital disorder of the external ear. The opening is usually located in front of the foot of the ear chakra, and rarely in the triangular fossa of the auricle or in the cavity of the earnail. It is usually asymptomatic. When pressed, a little thin mucus or milky sebum-like material may spill out of the fistula, causing local itching and discomfort. Asymptomatic or non-infected cases may be left untreated. If there is local itching and discharge, surgical excision is recommended. Definition 1. What is a fistula. A fistula is a pathological tube connecting a cavernous organ to the body surface, or between cavernous organs, usually with more than 2 openings. 2. What is a congenital preauricular fistula A congenital preauricular fistula, a common clinical congenital disorder of the external ear, is a relic of incomplete fusion of the auricular primordia of the first and second gill arches during development, and is genetically characterized as an autosomal dominant inheritance. The opening of the fistula is usually located in front of the foot of the ear wheel, but in a few cases it may be in the triangular fossa of the auricle or in the cavity of the earnail. This is referred to as an anterior auricular fistula. Fistulas are called anterior auricular fistulas because most open in front of the ear. Because it is present at birth, it is called a congenital preauricular fistula. Figure 1 Anatomy of a congenital preauricular fistula Clinical presentation Preauricular fistula can occur alone without other ear deformities. In a few cases, it may be accompanied by congenital malformations such as cleft palate, pars plana, auricular hypoplasia, and hereditary deafness. In severe cases, the fistula can branch extensively, forming multiple blind canals or even winding behind the ear and causing a postauricular infection. 1. There is a fistula in front of the foot of the ear wheel and a blind canal at the other end, which varies in depth and length and can be branched. 2. When infected, the area becomes red, swollen and pus-filled; repeated infections can form scarring or pus fistulas. 3, gently squeeze the fistula, there can be a little white secretion containing odor around the outflow So, how to find out if the preauricular fistula is infected? In case of infection, there is local redness, swelling, and pus, and the patient may sometimes have a fever Is surgery required for an infected preauricular fistula? Preauricular fistulas, whenever they are infected, can become infected repeatedly. How do I understand this statement? After the first infection, the redness, swelling and pus will subside with medication. The patient or the patient’s parents think it is healed. However, poor personal hygiene, eating irritating foods, catching a cold, and various other reasons can cause the fistula to become infected again. Therefore, an infected fistula can only be surgically removed. Figure 2 Diagram of fistula infection Prevention 1. It is advisable to eat a light diet, less spicy and stimulating food, mainly fresh eggs or lean meat, and avoid seafood. 2, usually more exercise to enhance physical fitness, improve resistance, in poor body resistance, inflammation is easy to invade. 3. Do not squeeze the fistula that has not been infected with your hands to protect the local cleanliness and prevent infection from occurring. 4, do not rub when the ear itches, so it is easy to rub the bacteria in, leading to inflammation. 5. In case of acute infection, the inflammation should be controlled by local hot compresses or antibiotics, and if an abscess has formed, an incision and drainage should be performed and surgery should be performed only after the inflammation has cleared. Treatment 1. Preauricular fistulas without a history of infection generally require attention to local hygiene around the fistula and avoid stimulating the diet. Preauricular fistulas with a history of infection require fistulotomy after the inflammation has cleared.