Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 West Yan Jiang Road, Guangzhou, 510120, China.
Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, 510120, China.
Eur Arch Otorhinolaryngol. 2019 Jul;276(7):1961-1967. doi: 10.1007/s00405-019-05431-7. Epub 2019 May 15.
To make otolaryngologists aware of the variant types of auricular sinus, we have performed a systematic review of patient diagnoses and presented our operative experiences.
From 2009 to 2013 in Sun Yat-Sen Memorial Hospital, there was a total of 20 children with the variant type of auricular sinuses including the comprehensive group. Postauricular sinuses have pits located posterior to the imaginary vertical line that is tangent to the external auditory canal. Sinuses that penetrate the cartilage and cause postauricular swelling or skin defects characterize type 1 of the variant type, while sinuses that adhere to the cartilage and cause preauricular or auricular swelling or skin defects characterize type 2. Patients with pits both anterior to and posterior to the imaginary vertical line comprise the comprehensive group. The patients who had infected underwent auricular sinusectomy using a dual approach, with accurate fistula tracing and proper cartilage removal.
Sixteen children who had infected sinus underwent surgery, while the other four were asymptomatic. Ten children (62.5%) of 16 patients were diagnosed as type 1 of the variant type, 2 (12.5%) as type 2. Four children (25%) were diagnosis as the comprehensive group. The asymptomatic could not be defined as the sinuses location were unknown. Sixteen children (100%) of 16 patients who underwent surgery had a history of misdiagnosis and treatment. These patients did not experience recurrence over a 5-year follow-up period.
The locations of pits and sinuses help to categorize the different types of auricular sinus. The effective method that we have described should be considered a viable way to reduce recurrence.
使耳鼻喉科医生了解耳窦的变异类型，我们对患者的诊断进行了系统回顾，并介绍了我们的手术经验。
2009 年至 2013 年，在中山大学孙逸仙纪念医院共有 20 例变异型耳窦患儿，包括综合组。耳后窦位于与外耳道相切的假想垂直线后面有凹坑。穿透软骨并引起耳后肿胀或皮肤缺损的窦为 1 型变异型，而附着于软骨并引起耳前或耳肿胀或皮肤缺损的窦为 2 型。综合组患者的凹坑位于假想垂直线前后。有感染的患者采用双入路进行耳窦切除术，准确追踪瘘管并适当去除软骨。
16 例感染性窦接受了手术，而另外 4 例无症状。16 例患者中有 10 例（62.5%）诊断为 1 型变异型，2 例（12.5%）为 2 型。4 例（25%）诊断为综合组。无症状的不能定义为窦的位置未知。16 例接受手术的患儿（100%）均有误诊和治疗史。这些患者在 5 年随访期间均未复发。
凹坑和窦的位置有助于对不同类型的耳窦进行分类。我们描述的有效方法应被认为是降低复发率的可行方法。
