Application of three-dimensional ultrasound for diagnosis of congenital preauricular fistula / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the application of real-time three-dimensional ultrasound in locating the course, the brand and the blind end of internal opening of congenital preauricular fistula.@*Methods@#Congenital preauricular fistula patients from Changhai Hospital were studied. All the cases were evaluated using two-dimensional and three-dimensional ultrasound before surgeries. The surgery findings were utilized as the gold standard. The imaging features of 3D ultrasound were described to determine the accuracy of the blind end location, the course of the main fistula tract and the branch tracts. The diagnosis was compared with the surgery findings.@*Results@#In 89 cases, among which there were 21 branch fistulae. There were 68 bend fistulae without branch. The diagnostic accuracy of both two-dimensional ultrasound and three-dimensional ultrasound was 100%. The accuracy in locating the blind end of internal opening, the course of the branch tracts with 3D ultrasound was 92.1%(82/89), 85.7%(18/21) , compared to 80.9%(72/89), 57.1%(12/21) with 2D ultrasound. It was obvious that 3D ultrasound had more advantages. These differences were statistically significant (χ2=4.8, P<0.05; χ2=4.2, P<0.05).@*Conclusions@#Compared with 2D ultrasound, 3D ultrasound can accurately locate the blind end of internal opening, the course, and the branch of preauricular fistula, clearly display the morphology and the spatial structure of preauricular fistulaand its surroundings. It has high clinical application value in preoperative imaging examination.

The Clinical Experiences of Congenital Preauricular Fistulectomy including Cartilage Excision

The preauricular fistula is a congenital malformation of the ear with a small opening in the preauricular area. In general, this malformation should be treated by excision after its infection is brought under control with antibiotics. For cosmetic consideration, we performed a elliptic incision around opening, and then we dissected along the fistula tract to the cyst without sacrificing too much soft tissues. From March 2001 to March 2005, 90 patients with 102 cases of fistulas were excised including a small portion of auricular perichondrium and cartilage, where they adhered closely. Then, histologic findings of preauricular fistula were studied. The histologic findings reveal that the fistular tract is very close to auricular cartilage, and the thickness of fistular epithelium and perichondrium are about the same. There was no specific complications related to this procedure. The recurrence rate for the excision with cartilage was 2 out of 102(2%). Results of surgery in all cases were satisfactory. It is important, in preauricular fistular excision, perichondrium and auricular cartilage should be excised to prevent recurrence.

Two Cases of Congenital Preauricular Fistula / 대한피부과학회지

Preauricular fistula is a congenital malformation that is presented as a small opening on the preauricular region. During embryonic development, six tubercles from the first and second branchial arches form the auricle, and the incomplete fusion of these tubercles results in congenital preauricular fistula. We report two cases of congenital preauricular fistula manifested as soft nodules with external openings on the preauricular area. It is apt to give rise to recurrent inflammation, so total fistulectomy with a curved incision along the crus of the ear helix was performed. Histopathologically, the fistulas were lined with stratified squamous epithelium, and skin adnexa and elastic cartilage were also present.

Melnick-Fraser Syndrome in the Same Family / 대한이비인후과학회지

Melnick-Fraser syndrome is a rare congenital anomaly that is characterized by preauricular fistula, branchial fistula, hearing impairment, and is often combined with renal anomaly. Preauricular fistula and branchial fistula can occur in the same individual, but their association with hearing impairment is very rare. The condition is inherited in an autosomal dominant mode. Recently, we experienced a case of Melnick-Fraser syndrome in a 32 years old male patient with familial tendency. We report this case with a review of literature.

Two Cases of Congenital Preauricular Fistula / 대한피부과학회지

The auricle develops from six auricular tubercles which originate from the mesenchyme of the first and second branchial arch. If a defective fusion of these tubercles occur, a preauricular fistula may be formed. We report two cases of congenital preauricular fistula manifested by soft nodules with external openings on the left preauricular area. Histologically, the fistulas are lined by stratified squamous epithelium, and elastic cartilage. and chronic inflammatory cell infiltration are also present.