Case Report

Fistulectomy in a 9-years old boy with pre-auricular fistula

Komang Soniananda Pradnyana Putri , Luh Witari Indrayani

Komang Soniananda Pradnyana Putri
Faculty of Medicine, Universitas Warmadewa, Bali, Indonesia. Email:

Luh Witari Indrayani
ENT Department, Sanjiwani General Hospital, Gianyar, Indonesia
Online First: April 30, 2021 | Cite this Article
Pradnyana Putri, K., Indrayani, L. 2021. Fistulectomy in a 9-years old boy with pre-auricular fistula. Intisari Sains Medis 12(1): 201-204. DOI:10.15562/ism.v12i1.976

Introduction: Preauricular fistule is a congenital malformation of the six auditory hillocks during the development of auricle. It mostly appears like a small pit close to the first ascending portion of the helix's anterior margin. The sebaceous glands secreted fluid through the opening of the fistule. Surgery is needed if the discharge is prolonged or if there was a repeated infection. It must be completely removed to prevent a recurrence. Accuracy is required in performing fistulectomy and aesthetics because the operation is in the area around the face.

Case description: Male patient, 9 years old, complained of itching in the right ear. Since birth, the patient has an abnormal hole (fistule) in front of his right ear, anterior of the medial supra auricle helix, round and the size of a tip of the pencil. The mother has the same history. There is an abscess near that hole that secretes yellow pus. That occurred twice this year and it has greatly disturbed the patient's activities at school. The patient was diagnosed with a preauricular fistula with an abscess in the right ear. An abscess drainage incision was performed and an antibiotic was given. Fistulectomy is performed after the acute infection subsides under general anesthesia. The patient underwent a simple fistulectomy surgery. The whole track and sinus were removed, the defect was undermined and sutured.

Conclusion: A simple fistulectomy is a good option as a standard procedure for preauricular fistula excision. It is especially useful as an alternative in cases where the other approaches are difficult to be performed.


Song JL, Wu H, Wu L, Mei Y, Feng X, Wu F. Experiences With The Surgical Management of Preauricular Sinus. B-ENT. 2019;15:311-317

Rogan JC. Essential ENT 2nd ed. Royal Berkshire Hospital. UK: Hodder Arnold; 2011.

Leopardi G, Chiarella S, Conti GE, Cassandro S. Surgical Treatment of Recurring Preauricular Sinus: Supra-Auricular Approach. Acta Otorhinolaryngologica Italica. 2008;28:302-305

Didit Y. Congenital Preauricular Sinus Management. Journal of Medicine Unram. 2017;6(1):1-7.

Widodo DW, Harba’I HM. Surgical management of preauricular fistula based on plastic-reconstructive algorithm. ORLI. 2019.49(1);83-92

El Anwar MW, El Aassar MS. Supra-auricular versus sinusectomy approaches for preauricular sinuses. International Archives of Otorhinolaryngology. 2016;20(4)390-393.

Heon Yoo, Dong Ha Park, Il Jae Lee, Myong Chul Park. A Surgical Technique for Congenital Preauricular Sinus. Arch Craniofac Surg.2015.16(2);63-66

Kim JR, Kim DH, Kong SK, Gu PM, Hong TU, Kim BJ, Heo KW. Congenital periauricular fistulas: possible variants of the preauricular sinus. Int J Pediatr Otorhinolaryngol. 2014;78(11):1843-8. doi: 10.1016/j.ijporl.2014.08.005.

No Supplementary Material available for this article.
Article Views      : 95
PDF Downloads : 46