Clinical Characteristics and Risk Factors for Postoperative Recurrence in Congenital Preauricular Fistula:A Large-Sample Analysis

ZHANG Ming; ZHANG Hongjia; ZOU Yihui

doi:10.3969/j.issn.1672-2922.2025.03.013

Abstract：Objective To report clinical characteristics of congenital preauricular fistula(CPF)and identify the key factors for repeated relapses after surgery to optimize treatment strategies.Methods Data from 912 patients with CPF(1262 ears)in the Department of Otorhinolaryngology Head and Neck Surgery of the Chinese People's Liberation Army General Hospital were included in this retrospective study,including demographics,fistula anatomy,concomitant malformations,local infection and treatments.Patients were grouped based on recurrence,i.e.initial recurrence and repeated recurrences.Univariate χ² test was used to determine correlation between potential risk factors and recurrence.Results Of the 912 patients,54.17%were female(male-to-female ratio=0.8:1),38.38%had bilateral fistulas,and overall right side lesions(32.02%)were slightly more common than left(29.61%)with no correlation between side and gender(P>0.05).Single fistula was the most common(98.34%),of which 85.58%were located in front of the helix foot.Additional ear deformities occurred in 16.01%and non-ear deformities occurred in 6.47%of the patients.Family history was positive in 2.85%of the cases.Infection was relatively common(60.62%),among which 67.32%lasted for longer than one year.More than half(55.94%)had received treatments before visiting our center,including medications(49.72%),open drainage(41.93%)and fistula resection(8.36%).A total of 410 patients(592 ears)were followed up after surgical treatment in our hospital,with an overall recurrence rate of 4.05%(24/592)including initial recurrence in 14 cases(2.36%)and repeated recurrences in 10 cases(1.69%).There was no correlation between gender,lesion side and relapses in the two groups(P>0.05).Preoperative infection and open drainage were common in both groups.Infection lasting>1 year and multiple open drainage procedures were correlated with the number of relapses(P<0.05).Conclusion CPF is more common in females,mostly unilateral as a single fistula in front of the helix foot,and can be accompanied by malformations in the ear and other parts of the body.Infection and open drainage are common.While overall postoperative recurrence rate in our center is relatively low,prolonged course of infection and repeated previous open drainage are risk factors for repeated recurrences.Comprehensive preoperative fistula assessment and radical resection are the key to reduce recurrence.