Patient's question:
My daughter has had recurrent inflammation in her right ear fistula for more than half a year. She has taken many anti-inflammatory medications and received penicillin shots, but none have been effective. There is no pus discharge every day. She has been on Daxin for four days, and now new granulation tissue has grown. What should I do? Urgent, urgent, urgent!!!!!!!!!Doctor's answer:
Hello: Preauricular fistula, also known as congenital preauricular fistula, is a remnant of the first branchial groove during embryonic development. It is usually unilateral. The fistula opening is often located on the anterior crus of the helix. The fistula may form branches or a treelike structure. The inner surface of the fistula is lined with stratified squamous epithelium, and the lumen contains desquamated epithelial cells and keratin. Due to infection and decomposition, it may discharge foul-smelling, curd-like secretions. This condition is generally asymptomatic, though occasionally, a small amount of mucus or purulent fluid may ooze from the fistula opening when squeezed. During infection, the local area may become red, swollen, and painful, or a abscess may form, with increased purulent discharge. Repeated infection and suppuration may lead to the formation of a purulent fistula or scars. In general, asymptomatic cases do not require treatment. If infection and suppuration occur, antibiotics or sulfonamide drugs can be administered, such as penicillin, 800,000 units per dose, intramuscularly (note: an allergy test should be performed); or erythromycin, 0.25g per dose, three times daily, orally. If an abscess forms, it should be incised promptly to drain pus, clean and disinfect the area, and change the dressing with povidone-iodine gauze. After the redness and swelling subside and the infection is controlled, the fistula can be surgically excised. It is essential to remove the entire fistula thoroughly during the first surgery, as residual fistula tissue may lead to recurrence, and subsequent surgeries are often less effective.Regarding diet, it is advisable to follow a light diet, primarily consisting of lean meat or fresh eggs, while avoiding seafood and shrimp.