Surgical management of preauricular based on plastic-reconstructive algorithm

Background: Preauricular fistula is a congenital malformation of the six auditory hillocks during the development of auricle, when an imperfect fusion of the first arch tuberculum to other tuberculums occurred and generated a tract. It is characterized by a nodule or a dent located adjacent to the external ear. An infection will create a swollen area in front of ear auricles with pain and suppuration. Fistula extirpation should be carried out after the acute infection subsides. Purpose: To evaluate surgery techniques with the lowest complication and recurrence rate. Case report: Reporting 4 surgical cases of prearicular fistula treated by Plastic-Reconstructive ENT Head and Neck surgery, among 26 cases of preauricular fistula diagnosed between 2015 to 2017 in Cipto Mangunkusumo General Hospital. Methods: Searching literature through Pubmed, Wiley, Proquest and Google Schoolar with keywords of “Preauricular fistula AND surgical treatment”. Further selection through clinical questions. Results: One journal presented a systematic review on the surgical outcome of preauricular sinus excision techniques. Reporting 4 cases treated by plastic-reconstructive surgery based on the systematic review above mentioned. Conclusion: The supra auricular approach could be recommended as a good technique for preauricular fistula, in particular for the infected and/or the recurrent cases.