Efficacy of Contouring-Assisted Resection in the Crus of Helix Cartilage Region for Congenital Preauricular Fistula.

Abstract

Aim: This study comparatively evaluates the efficacy and safety of contouring-assisted resection versus traditional fistula tract excision in the crus of helix cartilage region for the treatment of congenital preauricular fistula (CPF).

Methods: This retrospective cohort study recruited 198 CPF patients who underwent surgical treatment at Ruijin Hospital between January 2018 and June 2024. Based on surgical technique, patients were divided into a contouring group (n = 98), who underwent contouring-assisted resection involving systematic dissection along the anterior and deep surfaces of the crus of helix cartilage while preserving the cartilage framework, and a traditional surgery group (n = 100), who underwent conventional fistula tract identification and excision. Baseline characteristics, recurrence rate, operative time, postoperative complications, and patient satisfaction were statistically compared between the two groups.

Results: The recurrence rate was significantly lower in the contouring group than in the traditional group (2.0% vs. 18.0%, p < 0.001). Patients in the contouring group experienced significantly longer operative time (p < 0.001), while intraoperative blood loss did not differ significantly between groups. The overall complication rate was significantly lower in the contouring group (4.1% vs. 20.0%, p < 0.001), with a particularly reduced rate of incision-related infection in this group (1.0% vs. 8.0%, p = 0.044). Patient satisfaction scores were significantly higher in the contouring group (p < 0.001).

Conclusions: The contouring-assisted resection approach was associated with a significantly lower recurrence rate and higher patient satisfaction compared with traditional fistula tract excision, without an increase in specific complications such as chondritis, hematoma requiring intervention, or persistent sensory abnormality. These observations suggest this method is an effective and safe surgical option for patients with CPF in the crus of the helix region.