[Surgical treatment of preauricular fistula. A follow-up study]

Our aim was to evaluate the results of surgery on preauricular fistulas over a ten-year period and to determine the postoperative recurrence rate and the factors responsible.

Forty-three patients with 51 preauricular fistulas, who had been operated on in the period, 1 August 1990 to 1 August 2000, at the Department of Otolaryngology, Aarhus University Hospital, were asked to participate in a follow-up examination. Thirty-three patients turned up for examination, four patients were interviewed over the telephone, and for the rest the data available from the medical records were used.

Surgical extirpation was performed on 51 fistulas. Eight fistulas had previously been operated on. The recurrence rate of the fistula primarily operated on at our department was 5%. The recurrence rate of secondary surgery was 63%. Five fistulas were infected at the time of surgery, three recurred. Seven patients developed a postoperative abscess, six of whom had a recurrence. All the fistulas were blind-ended. In 94% of the histology tests, the fistula was lined with multilayered squamous epithelium. Sixteen patients had a family history of the condition.

Preauricular fistula is a benign disease that often stays asymptomatic, but can become troublesome if infected. The treatment is surgical extirpation. The recurrence rate rises if the fistulas are infected at the time at surgery or if there has been an earlier attempt of extirpation. This emphasises the importance of an extended knowledge of the disease, so that patients can be referred to an ENT specialist should symptoms occur.