Rozpoznawanie i leczenie przetok przedusznych u dzieci

Abstract

Preauricular fistulas are not uncommon congenital disorders in children. They are associated with imperfect auricle formation as a consequence of incomplete fusion of the auditory hillocks of the first and second branchial arches. The aim of this study was to present diagnostic methods with evaluation of treatment results of preauricular fistulas in children. We analysed retrospectively clinical and epidemiological features, diagnostic methods and treatment results of the patients with preauricular fistula attended in the Otolaryngology Department of Medical University in Gdańsk. Between 1995 and 2009 in the Department of Otolaryngology MGUed 23 children (13 girls and 10 boys) were treated for preauricular fistulas. The age of the children ranged between 2 to 16 years (median 7.7). The fistula was recognized on the left side in 14 children, in 6 on the right and bilaterally in 3 children. The diagnosis was based on the presence of a cutaneous fistula in the region of the helix's anterior crus with inflamed surrounding and purulent discharged in physical examination and in radiological imaging (MRI). Patients were treated surgically in the classical way and using Prasada's method including resection of the cutaneous fistula and cyst with a part of the helix. Squamous epithelium in the resected fistulas was found in 91.3% of the children. No recurrence was observed, good cosmetic outcome was achieved in all children. Each patient with bilateral preauricular fistula needs to be diagnosed for congenital disorders of the middle ear and kidneys. MRI may be useful in establishing the location of the fistula. Surgical treatment is not necessary in preauricular, blind-ended sinuses. In the postoperative material of the sinus squamous epithelium is found.