Ear fistula and cyst, congenital Q17.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 31.05.2021

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Synonym(s)

Auricular fistula; Branchiogenic fistula; Congenital ear fistula; Congenital ear fistula and cyst; Congenital preauricular fistula; fistula auris congenita; Preauricular fistula

Definition
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Unilateral or bilateral (unilateral in about 85% of patients), congenital, manifesting in childhood or adolescence (less frequently in early adulthood), potentially combined with other anomalies, branchiogenic malformation of the 1st gill duct.

See also cysts and fistulas, branchiogenic.

Branchiogenic malformations give rise to cysts and sinuus, which are drained externally through the skin at certain sites on the one hand, and internally into the pharynx on the other. On the skin they appear as red-brown, smooth-surfaced or verrucous papules or as inconspicuous indurations, but also as oozing, granulomatous inflammations (usually they then become clinically conspicuous).

Manifestation
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m:w=1:1; congenital fistulas are usually discovered between the ages of 2 and 16 years.

Clinical features
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The external fistula opening is located above or in front of the tragus or in the area of the ascending helix. It is perceived as a 0.3-0.5 cm large, reddish-brownish nodule resembling a foreign body granuloma; often with a visible central porus. Rare small ulcer. Usually the porus is not inflammatory. However, it can also develop folliculitis-like inflammatory symptoms with purulent secretion.

Accumulates stubborn auditory canal eczema.

Diagnosis
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Radiological presentation of the fistula tract after probing and injection of contrast medium.

Therapy
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Excision following radiographic imaging of the fistula tract after probing and injection of contrast medium. A specialist excision is recommended!

Literature
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  1. Ellies M et al (1998) Clinical evaluation and surgical management of congenital preauricular fistulas. J Oral Maxillofac Surgery 56: 827-830
  2. Kuczkowski J et al (2011) Diagnosis and treatment of preauricular fistulas in children. Otolaryngol 65: 194-198
  3. Martin-Granizo R et al (2002) Methylene blue staining and probing for fistula resection: application in a case of bilateral congenital preauricular fistulas. Int J Oral Maxillofac Surgery 31: 439-441
  4. Nakano M et al (1999) Congenital cheek fistula: a report of three cases. Br J Plast Surgery 52: 311-313
  5. Nicollas R et al (2000) Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol 55: 117-124
  6. Song J et al (2015) Analysis of chromosome regions 8q11.1-q13.3, 1q32-q34.3 and 14q31.1-q13.3 in a Chinese family with congenital preauricular fistula. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 32:472-475
  7. Zou F et al (2003) A locus for congenital preauricular fistula maps to chromosome 8q11.1-q13.3 J Hum Genet 48: 155-158

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 31.05.2021