Patient's question:
The child was born a few days ago, and recently, for some reason, they have been scratching their ears frequently. How can I tell if the child's preauricular fistula is infected?Doctor's answer:
Some babies are born with a small hole near the front of their ear and temples, which is commonly referred to as a "granary eye" in folk lore. Some elderly people even call it a "front granary," believing it predicts future wealth and prosperity. Of course, this is purely ignorant superstition. In reality, this is a congenital malformation called an "ear canal fistula," which is formed due to residual developmental abnormalities in the embryo.An ear canal fistula is a hollowed-out patch of skin that possesses all the characteristics of normal human skin, including epidermis, hair follicles, sweat glands, and sebaceous glands. Normally, shed epidermis and sebum secretions from the fistula accumulate inside and cannot be expelled. If it is exposed to bacteria, it can become infected and inflamed.
Babies with ear canal fistulas usually experience only mild itching in the affected area and no other symptoms. Occasionally, gentle pressure around the small hole may cause a small amount of slightly smelly white discharge to ooze out. However, if secondary infection occurs, the area may become red, swollen, warm, and painful, leading to pus formation. Once the abscess ruptures, it is difficult to heal, and the wound may reopen repeatedly, forming granulation tissue. Even if scars form, they can still become reinfected and inflamed, causing significant pain to the baby. Parents can use these characteristics to perform self-examinations.
The most fundamental treatment for an ear canal fistula is surgical removal of the fistula and any connected cysts. If the fistula has already become infected, it should be surgically treated after the infection is controlled. For fistulas without infection, avoid squeezing them with hands. Instead, use 70% alcohol to wipe the fistula opening and maintain local cleanliness to prevent infection.