Surgical treatment of variant preauricular fistula complicated with postauricular abscess in children
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摘要: 目的 总结以耳后脓肿为临床表现的儿童变异型耳前瘘管的临床经验，提升诊疗水平。方法 回顾性分析11例以耳后脓肿为主要临床表现的耳前瘘管患儿的临床资料，其中10例切开排脓、控制感染后进行手术治疗，1例行感染期耳前瘘管切除术。术中采用亚甲蓝示踪瘘管走行，整体切除瘘管及耳后感染组织。术后定期随访。结果 11例患者瘘口均位于耳轮脚，行耳前耳后双切口耳前瘘管切除术后随访1年以上无复发。结论 采取耳前耳后双切口手术可有效治疗以耳后脓肿为临床表现的儿童变异型耳前瘘管。术前仔细查体、术中将瘘管连同其周围附着的软骨整体切除可避免误诊、漏诊，预防术后复发。Abstract: Objective To summarize the clinical experience in treating children with variant preauricular fistula who present with posterior auricular abscess, and to improve the diagnostic accuracy and therapeutic outcome.Methods The clinical data of 11 children with preauricular fistula with retroauricular abscess as the main clinical manifestation were analyzed retrospectively. Among them, 10 patients underwent surgical treatment after infection control, and 1 patient underwent preauricular fistula resection during infection period. During the operation, methylene blue was used to trace the fistula, and the fistula and the infected tissue behind the ear were removed as a whole. Follow up regularly after operation.Results The fistulas of the 11 patients were all located at the helix crus. After the auricular fistula resection with double-incision, the patients were followed up for more than 1 year without recurrence.Conclusion Children with variant anterior auricular fistula who manifested with postauricular abscess could be successfully managed by Preauricular fistula resection with Double-incision. Careful physical examination before operation and the complete removal of the fistula and the attached cartilage during the operation can avoid misdiagnosis and postoperative recurrence.
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Key words:
- congenital preauricular fistula /
- posterior auricular abscess /
- child
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