Congenital preauricular fistula is a clinically common congenital disorder of the external ear caused by incomplete fusion of the auricular primordia of the 1st and 2nd gill arches during embryonic development and is an autosomal dominant disorder. The prevalence of congenital preauricular fistula is higher in the Oriental population, about 10-14%, unilateral, more common on the right side than on the left, and more common in women than in men. Because fistulas do not usually cause discomfort, patients do not seek medical attention. Surgical excision is the only effective treatment, and the indications for surgery are infection or fistula spillage. Once infected, fistulas are prone to recurrence, and if they do not heal, local abscesses and scarring can form, making complete surgical removal difficult, with a reported recurrence rate of 19-40%. The correct surgical approach is the key to improving the success of surgical treatment. Congenital preauricular fistulas are often blind tubes with hair follicles, sweat glands, and sebaceous tissue, and the lumen is a complex squamous epithelium, which can become infected due to poor drainage of secretions within the tube and can form cysts or abscesses. If the infection is recurrent for a long time, the skin near the fistula may become ulcerated, scarred, and the wound may not heal for a long time or form several small pus-filled holes. The only way to control the infection and prevent recurrence is to remove the fistula completely and clear the lesion. In patients with congenital preauricular fistula combined with infection, surgery was advocated in the past after complete control of inflammation, but in recent years, surgery during the infection phase is preferred. Some scholars believe that the fistula breaks down during the infection period and stimulates the production of fresh granulation tissue, which is clearly distinguishable from the surrounding tissue and can be easily removed completely, and the fistula stump and small branches wrapped in the granulation can be easily removed together to avoid recurrence. In order to completely excise the preauricular fistula, in addition to removing the subcutaneous fistula tissue, the cartilage of the pedicle of the ear is also removed free to ensure the integrity of the fistula.