[Efficacy and prognosis of an innovative concealed incision approach combined with microscopic excision for preauricular fistula].

Objective

To investigate the efficacy and prognosis of an innovative concealed incision approach combined with microsurgical techniques in the excisional treatment of preauricular fistula.

Methods

A retrospective analysis was conducted on 87 paediatric patients with preauricular fistula admitted between January 2020 and May 2025. Patients were categorised into a study group （18 cases, innovative concealed cosmetic incision combined with microsurgical technique） and a control group （69 cases, conventional preauricular fusiform incision with direct visualisation）. Both groups underwent six-month postoperative follow-up. Surgical outcomes,pain levels,wound healing,aesthetic degree, complications and short-term prognosis were compared between groups.

Results

Intraoperative blood loss was significantly lower in the study group than the control group （P<0.05）, while operative duration showed no statistically significant difference （P>0.05）. Comparison of the pain scores（FLACC） at 4 hours and 24 hours postoperatively showed that the study group scored lower than the control group at both time points （P < 0.05）. Comparison of aesthetic degree of incision healing revealed significantly higher SBSES scores in the study group versus the control group （P<0.05）. Long-term follow-up MAPS scores for aesthetic degree of incision healing were significantly lower in the study group than in the control group （P<0.05）. The overall complication rate showed no statistically significant difference between groups （P>0.05）.No recurrence was observed in either group during postoperative follow-up.

Conclusion

The innovative concealed cosmetic incision approach combined with microsurgical techniques not only achieves thorough excision of fistula tissue but also offers an aesthetically concealed incision. Microscopic dissection of the fistula allows clear anatomical visualization without necessitating en bloc removal of preauricular tissue, creating satisfactory wound healing and a safe, reliable procedure. Compared with the traditional preauricular fusiform incision, the innovative concealed cosmetic incision combined with microsurgical techniques offers superior aesthetic outcomes in terms of healing appearance. This incision method is readily mastered by surgeons while meeting the aesthetic expectations of paediatric patients and their families, which is worthy of clinical promotion and application.