Surgery for preauricular fistula is a relatively routine procedure in otolaryngology. The procedure involves, in the first step, disinfection and spreading of towels to ensure a clean surgical area. In the second step, lidocaine with epinephrine or general anesthesia with local infiltration injections of epinephrine saline only is used to minimize the patient’s reaction and to reduce bleeding. In the third step, a pike incision is made in the skin around the fistula and the surrounding tissue is separated along the incision to expose the fistula. In the fourth step, the fistula is separated along the path of the fistula draining the fistula, which usually runs towards the foot of the ear, mostly ending at the cartilage at the foot of the ear, but in some cases passing through the cartilage at the foot of the ear, or even behind the ear. In the fifth step, if the fistula passes through the cartilage, the cartilage is partially removed; however, if the fistula passes behind the ear and there is a postauricular fistula, a corresponding pike incision is made behind the ear; the fistula is separated from behind the ear and forward, and after both sides are separated at the same time, the fistula can be completely removed in the middle. The sixth step is to clean and rinse the surgical cavity and then to stop the bleeding with electrocoagulation, after the cavity is clean the incision can be sutured, and the seventh step is to dress the wound with pressure and end the surgery.