CLINICAL-EVALUATION AND SURGICAL-MANAGEMENT OF CONGENITAL PREAURICULAR FISTULAS

Purpose: The retrospective investigation evaluated the clinical data o n patients with a preauricular fistula with respect to demographic fac tors, symptoms, preoperative diagnosis, and surgical therapy. Follow-u p studies served to critically assess the outcome of the operations. P atients and Methods: The records of 62 patients were studied. Patients were divided into two groups: those operated on for the first time fo r a preauricular fistula and those operated on for a recurrence. Contr olled follow-up was performed by means of a standardized questionnaire filled out by both the patients' physicians and the patients themselv es. Results: The mean age of patients operated on for the first time w as 16 years, and that of patients operated on for a recurrence was 22 years. Although the overall rate of recurrence was 21%, it differed wi dely between groups (14% in first operations and 42% in patients opera ted on for the first time for a recurrence). These figures are within the lower range of the recurrence rates previously reported. Serious s ide effects, such as persistent damage to the facial nerve, were not o bserved. Conclusions: Operative management of a preauricular fistula i s a treatment with few side effects that should be offered to each pat ient with such a malformation. Because the first operation is decisive for the further course of the condition, surgery should be performed under optimum conditions to avoid recurrence.