Patient's question:
My child has a small opening in the auricle, which is often red and swollen, and it also itches. The examination revealed that they have preauricular fistula. What are the causes of preauricular fistula?Doctor's answer:
Congenital preauricular fistula is a common otological disease. It is caused by the failure of fusion of the first and second pharyngeal arches or incomplete closure of the first pharyngeal groove during embryonic development. A fistula is a blind tube that may branch and curve, with its external orifice usually located above and in front of the helix crus. The lumen is lined with stratified squamous epithelium and contains desquamated epithelial cells and keratin. Squeezing the surrounding fistula may occasionally cause a small amount of viscous, sebaceous gland-like material to ooze from the fistula. Once infected, it becomes red, swollen, painful, and purulent, and can recur repeatedly. This condition is an autosomal dominant genetic disease with incomplete penetrance.The first pharyngeal groove is a remnant caused by incomplete fusion during embryonic development. Fistula orifice: Usually located in front of the helix crus. The fistula may branch, with its wall lined with squamous epithelium and its lumen containing desquamated epithelial cells and keratin. During infection, it forms malodorous secretions, and repeated infections can lead to the formation of cysts or abscesses.
Guidelines:
If there is no history of infection, this condition does not require treatment. During acute infection, systemic antibiotics should be used to control inflammation. For those who have formed an abscess, drainage should be performed first. If there is a history of infection, the fistula removal surgery can be performed after the infection is controlled. A light diet is recommended, with lean meat or fresh eggs as the main components, while seafood such as shrimp and fish should be avoided.