My baby’s ears have not been injured. Why is there a pinhole-sized hole?

Moreover, it is all right for such a hole to grow on one's own ears. If it grows on a child's ear, some mothers will always be tempted to do something with it. Once some secretions emerge from the hole, the mother wants to squeeze it or use a toothpick to dig it out, but after that, the child's ears will bulge up!

1. This small hole is called "preauricular fistula"

This mysterious cave actually comes from the "womb". We can't clean it up at will.

When the child is still in the mother's stomach, only 5-6 weeks of gestation, the development of the ear is still just like the original structure of fish gill, we call it "gill arch". It will develop into six ear mounds, and then continue to recombine and fuse, eventually forming the auricle.

However, if the fetal ear mound does not fuse smoothly, just like a steamed bun opened, it will form a fistula. More than 90% of the fistulas have openings in front of the helix casters, which are the small holes we see.

According to statistics, there are 1-2 cases of preauricular fistula in every 100 people. Some preauricular fistulas are hereditary (incomplete autosomal dominant inheritance), especially bilateral fistulas.

2. Why do small holes come out of secretions, and clean up secretions can also cause abscesses?

Most preauricular fistulas have no symptoms, but some may have a little "taste".

This is because the fistula is covered with stratified squamous epithelium, and there are glands such as sebaceous glands and sweat glands. These epithelial cells continue to fall off and accumulate in the fistula, forming dander, and the glands secrete fluid, causing the fistula to swell and become cystic, and smelly sebum will overflow the fistula.

These secretions are not that they cannot be cleaned up, but they cannot be cleaned up “at-will”. Squeezing the fistula, or inserting dirty toothpicks, acne needles, and other utensils, it is easy to introduce bacteria into the fistula, once an infection is caused, it may quickly form an abscess.

It is a good thing to be clean, but it may be bad if we clean and take care of it incorrectly.

3How to cure preauricular fistula?

First of all, we will make a small cut in the abscess and release a large amount of yellow-green pus from the abscess. It is necessary to clean the abscess cavity thoroughly, but also take part of the pus for bacterial culture.

Next, we need to change the dressing daily. Considering that the most common pathogen causing the infection is Staphylococcus aureus, we usually use amoxicillin as an antibacterial drug.

Ideally, after five days of treatment, the pus disappears completely, the wound is healed, and the result of the bacterial culture is in line with our initial judgment, then the swelling can come to an end.

Parents will feel distressed, and no one wants their children to suffer this pain. To make matters worse, preauricular fistulas are prone to repeated infections. What should we do?

4. If the fistula is repeatedly infected, surgical removal is recommended

Complete removal of the preauricular fistula surgery is the only effective treatment for repeated preauricular fistula infections. In addition, if the fistula often has secretions but is not yet infected, we can also choose preventive surgical resection.

Of course, most of the fistulas without any symptoms or signs of infection do not need to be intervened, but pay attention to observation.

5. Will preauricular fistula affect hearing?

No, but we should pay attention to hearing screening.

If the ear mound is reorganized and fused, other abnormalities are caused at the same time, and other ear deformities may be combined, which will cause hearing loss, such as external auditory canal atresia, middle ear ossicular chain deformity, etc. To avoid ignoring other ear deformities, hearing screening is necessary.

In addition, there are some syndromes, such as mumps-ear-renal syndrome (branchio-oto-renal, BOR), which is characterized by deafness, preauricular fistula, branchial cleft cyst, ear deformity or kidney abnormality, etc., often in families history.

If children with preauricular fistulas have hearing loss or have ear-kidney malformations, neck fistulas, etc., then it is necessary to investigate the possibility of the syndrome. However, the incidence of these syndromes is extremely low (the incidence of branchial ear renal syndrome is 1 in 40,000), and there is no need to routinely perform renal color doppler ultrasound screening for children with isolated preauricular fistulas.

Pre-auricular fistula is indeed a small hole, no matter how young a child develops a fistula, hearing screening must be performed, especially for newborns.

So in daily life, how to care for preauricular fistula? Remember these 3 Tips:

  • When there is no secretion, no special cleaning and care is needed daily;
  • If there is a secretion from the fistula, do not squeeze or extend it into a needle-like object to clean it up. Use an alcohol swab or an iodine swab to gently wipe it away;
  • If you find redness, swelling, tenderness on the skin, you need to be alert to the possibility of infection, please consult a doctor in time.

Pre-auricular fistula is not terrible, it is terrible if you don’t know how to care. The good habits developed since childhood can benefit children throughout their lives.