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Liu C, Niu C. Concealed incision for resection of classical preauricular fistula. EAR, NOSE & THROAT JOURNAL 2025; 104:370-374. [PMID: 35942980 DOI: 10.1177/01455613221118891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
ObjectiveTo introduce a new method of preauricular fistula resection and discuss its clinical efficacy.MethodsClinical data of 40 patients with 40 classical preauricular fistulas in our hospital were collected. The patients comprised of 19 male and 21 female patients aged 3-60 years. The fistula and part of the related cartilage were completely removed by a concealed incision on the inner side of the auricular crus, and the opening of the fistula was retained. The postoperative efficacy was analyzed.ResultsThe operation time ranged from 15 to 30 minutes (mean, 25 minutes), and the blood loss ranged from 4 to 8 mL (mean, 5 mL). After complete fistula resection, the wound was closed with interrupted sutures. Dressing changes started 2 days after surgery and performed once a day, and the wound sutures were removed 7 days after surgery. All patients were followed up for 6 to 12 months (mean, 8.7 months) after surgery. Except for one patient with mild wound pain after suture removal, no patients developed infection or recurrence.ConclusionUse of a concealed surgical incision for treatment of a classical preauricular fistula has good results. There is no obvious scar on the ear after surgery and the procedure does not affect the facial appearance. It not only completely removes the lesion but also meets the patient's esthetic needs.
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Affiliation(s)
- Chunmiao Liu
- 1Department of Otolaryngology, Bao Di Clinical College of Tianjin Medical University, Tianjin Bao Di Hospital, Tianjin, China
| | - Chunsheng Niu
- 1Department of Otolaryngology, Bao Di Clinical College of Tianjin Medical University, Tianjin Bao Di Hospital, Tianjin, China
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Park J, Choi SJ, Im GJ, Jung HH, Park E. Safety and efficacy of preauricular fistulectomy with fascia-anchoring suture technique: A large case series. Am J Otolaryngol 2024; 45:104188. [PMID: 38101133 DOI: 10.1016/j.amjoto.2023.104188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE This study aimed to analyze the safety and efficacy of preauricular fistulectomy with fascia-anchoring suture technique through large case series. In addition, differences in surgical outcomes according to preoperative status and age were investigated. METHODS In this retrospective study, 380 patients (450 ears) with preauricular fistula (PAF) who underwent preauricular fistulectomy with fascia-anchoring suture technique by a single surgeon (E.P) were enrolled. Patients were divided into fresh, previous incision and drainage (I&D), and the revision surgery groups according to the preoperative status. Additionally, they were divided into adult and pediatric groups according to age. Patient's demographics, postoperative infections, and recurrence rates were analyzed. RESULTS The mean age of the patients was 28.3 years, and there were 119 males and 261 females. Out of 450 PAFs (n = 281 in the fresh groups, n = 119 in the previous I&D groups, and n = 50 in the revision groups), 21 (4.7 %) cases had postoperative infections and 12 (2.7 %) cases had recurrence. There was no difference in postoperative infections, regardless of the preoperative condition (I&D group, p = 0.701; revision group, p = 0.658). The recurrence rate was higher in the revision group than in the fresh and I&D groups (p = 0.004). There was no significant difference in postoperative infection (p = 0.221) or recurrence (p = 0.161) between adults and children. CONCLUSIONS The study found that performing preauricular fistulectomy with a fascia-anchoring suture technique led to low rates of postoperative infections and recurrences. These positive outcomes were consistent across different patient groups categorized by preoperative status and age, indicating the technique's safety and effectiveness for all patients with preauricular fistulas.
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Affiliation(s)
- Jaehyung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Soo Jeong Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Gi Jung Im
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hak Hyun Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Euyhyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
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Yuan L, Yang R, Deng H. Auricular fistula: a review of its clinical manifestations, genetics, and treatments. J Mol Med (Berl) 2023; 101:1041-1058. [PMID: 37458758 DOI: 10.1007/s00109-023-02343-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
Auricular fistula is a common congenital auricular malformation, characterized as a small opening in the skin and a subcutaneous cyst. It can be classified in different ways according to positions of pits and directions of fistula tracts. The term preauricular fistula and variant type of preauricular fistula (postauricular fistula) are used. Auricular fistula prevalence varies in countries and populations, and its actual prevalence is presently unknown. The most accepted and widely cited theory of auricular fistula etiopathogenesis is an incorrect or incomplete fusion of six auricular hillocks that are mesenchymal proliferations. Auricular fistula can occur either sporadically or genetically. The pattern in inherited cases is thought to be incomplete autosomal dominant, with variable expressions, reduced penetrance, and inapparent gender differences. Auricular fistula has several forms and is reported as being a component of many syndromes. In the field of genetics, currently, there is no related review to comprehensively summarize the genetic basis of auricular fistula and related disorders. This article provides a comprehensive review of auricular fistula, especially congenital preauricular fistula, which accounts for the majority of auricular fistula, by summarizing the clinical manifestations, histological and embryological development, genetics, examinations, and treatments, as well as syndromes with auricular fistula.
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Affiliation(s)
- Lamei Yuan
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Disease Genome Research Center, Central South University, Changsha, 410013, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Ruikang Yang
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Disease Genome Research Center, Central South University, Changsha, 410013, China
| | - Hao Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Disease Genome Research Center, Central South University, Changsha, 410013, China.
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
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Jiang Y, He T, Liu W. Resecting the Lesion Combined with Local Flap Repairing for the Treatment of Infected Congenital Preauricular Fistula. Int J Gen Med 2021; 14:7285-7292. [PMID: 34737622 PMCID: PMC8560080 DOI: 10.2147/ijgm.s331698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Evaluating the treatment of infected preauricular fistulas by resecting the lesion combining with local flap repairing. Patients and Methods This clinical study was implemented in Ningbo No. 1 Hospital and Wuhan No. 1 Hospital of China. We included 100 cases who were diagnosed with infected preauricular fistulas and needed further surgery treatment. Among them, 50 patients experienced the conventional treatment including a fully infection control following with a surgery to remove preauricular fistulas (conventional treatment group). Other 50 patients only took some simple pre-operation treatment for about 1-7 days, and then preauricular fistulas resection combining local flap repairing were performed regardless of the infection (local flap repairing group). The duration of total treatment procedure, healing index, and total cost were observed. Results All patients were discharged at about 7 days after surgery, the duration of the post-operative period had no significant difference between groups. The total duration of treatment (from any first treatment time point to patient discharge) was only 13.98±2.14 days in the local flap treatment group compared with that of 43.06±8.24 days in the conventional treatment group. Further, the total cost of treatment per patient in the local flap repairing treatment group was about 47.1% of that in the conventional treatment group. Conclusion For the treatment of infected preauricular fistula, performing a lesion removing surgery combining a local flap repairing can shorten the total treatment course, relieve patient's suffering, reduce treatment cost, and achieve a better clinical prognosis.
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Affiliation(s)
- Yuanming Jiang
- Department of Otolaryngology, Wuhan No. 1 Hospital, Wuhan, Hubei, 430022, People's Republic of China
| | - Ting He
- Department of Otolaryngology, Wuhan No. 1 Hospital, Wuhan, Hubei, 430022, People's Republic of China
| | - Wei Liu
- Department of Otolaryngology, Wuhan No. 1 Hospital, Wuhan, Hubei, 430022, People's Republic of China
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Song Y, Zhang N, Yu Y. Diagnosis and treatment of eosinophilic fasciitis: Report of two cases. World J Clin Cases 2021; 9:8831-8838. [PMID: 34734063 PMCID: PMC8546818 DOI: 10.12998/wjcc.v9.i29.8831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/05/2021] [Accepted: 08/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Eosinophilic fasciitis (EF) is a rare disease characterized by inflammation of the fascia with immune system involvement. Failure to promptly diagnose and treat this disease can seriously affect the quality of life of patients. However, no clear and uniform criteria for diagnosis and treatment exist.
CASE SUMMARY In this paper, we report two cases of EF, both of which showed symmetrical limb swelling and rigidity, increased eosinophils in the peripheral blood and bone marrow, increased red blood cell sedimentation rate, increased antinuclear antibody titer, and pathological changes in the tissues such as eosinophil and lymphocyte infiltration. Both patients were treated with hormones and cyclosporine, and showed significant improvements in their conditions.
CONCLUSION EF is an autoimmune disease causing swelling and sclerosis of the fascia and eosinophilia. It is diagnosable by magnetic resonance imaging, positron emission tomography-computed tomography, blood routine tests, and bone marrow puncture. Glucocorticoids and immunosuppressants are effective treatments.
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Affiliation(s)
- Yang Song
- Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Ning Zhang
- Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Yue Yu
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Tian CH, Chen XJ. Severe bleeding after operation of preauricular fistula: A case report. World J Clin Cases 2021; 9:8932-8937. [PMID: 34734077 PMCID: PMC8546837 DOI: 10.12998/wjcc.v9.i29.8932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Severe eyelid edema and blood accumulation in the submandibular space after preauricular fistula surgery is rarely reported.
CASE SUMMARY We report a 4-year-old girl with eyelid edema and swelling of the submandibular region after preauricular fistula resection under general anesthesia. When drug treatment failed, neck computed tomography examination was performed, which confirmed severe bleeding in the submandibular space. Later, exploration and ligation of the superficial temporal artery were performed under general anesthesia to stop the bleeding. The child was successfully treated, and there were no abnormalities over 1 year of follow-up.
CONCLUSION When severe bleeding occurs after preauricular fistula surgery, superficial temporal artery rupture should be considered as a cause.
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Affiliation(s)
- Chun-Hui Tian
- Department of Otolaryngology—Head and Neck Surgery, Suzhou Hospital of Anhui Medical University, Suzhou 235200, Anhui Province, China
| | - Xiao-Juan Chen
- Department of Otolaryngology—Head and Neck Surgery, Suzhou Hospital of Anhui Medical University, Suzhou 235200, Anhui Province, China
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Shehan JN, Levi JR. An unexpected cyst of the ear lobule. Am J Otolaryngol 2021; 42:102976. [PMID: 33610922 DOI: 10.1016/j.amjoto.2021.102976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/13/2021] [Indexed: 11/15/2022]
Abstract
Branchial cleft anomalies (BCA) are among the most common congenital anomalies found in the pediatric head and neck. The embryology of these congenital anomalies is well understood, which allows clinicians to anticipate their diagnosis when a pediatric patient presents with a head or neck mass. The predictable anatomy of the various types of BCA allows for improved surgical planning to prevent recurrence and ensure complete resection. This report details an unusual location of a first BCA located in the ear lobule of a 10-month old male. There has been no documented first BCA at the ear lobule in the literature.
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Affiliation(s)
- Jennifer N Shehan
- Boston Medical Center, Department of Otolaryngology - Head & Neck Surgery, United States of America.
| | - Jessica R Levi
- Boston Medical Center, Department of Otolaryngology - Head & Neck Surgery, United States of America; Boston University School of Medicine, Boston, MA, United States of America
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Khardali MH, Han JS, Kim SI, Jin HJ, Lee SM, Han JJ, Park JM, Park KH. Clinical efficacy of standard simple elliptical incision following drain-less and subcutaneous suture technique in preauricular sinus surgery. Am J Otolaryngol 2020; 41:102465. [PMID: 32247708 DOI: 10.1016/j.amjoto.2020.102465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND The purpose of this study was to review our surgical strategy and outcomes of drain-less, subcutaneous suture technique in standard simple elliptical incision on preauricular sinus (PAS) cases. METHODS The clinical records of 198 patients (247 ears) with PASs who were operated via standard simple elliptical incision with drain-less, subcutaneous suture technique by a single surgeon (K.H.P.) between January 2008 and December 2018 were reviewed for analysis. Patients' demographics, location of PASs, previous incision and drainage (I&D) history, previous surgical excision history, duration of follow-up, postoperative infection after surgery, and recurrence after surgery were analysed. RESULTS Out of 247 PASs, 18 (7.3%) cases had postoperative infections and 11 (4.5%) cases showed recurrence. Postoperative infection rate were higher in previous I&D groups (PIDGs, 9.8%) and previous fistulectomy groups (PFGs, 10%), and also recurrence rates of PFGs (10%) was higher than those of fresh cases. However, there were no statistically significant differences between these groups. In addition, PAS patients with postoperative complications such as infection and recurrence were more common in male patients. CONCLUSION We report a method of drain-less standard simple elliptical incision for the surgical removal of PAS and the outcomes of the surgery. Our method showed a low recurrence rate and low chance of wound infection postoperatively not only in fresh cases but also in pre-operative I&D cases and even previous fistulectomy cases. In conclusion, our method is proposed as an effective and safe method in all kind of patient groups, without presenting post-operative discomfort to patients.
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