Collaural Fistula
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Collaural fistula or cervico-aural fistula is a type of
fistula In anatomy, a fistula (: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other h ...
whose openings are at external auditory canal and the neck, usually in the upper part of anterior border of
sternocleidomastoid The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the acces ...
muscle. It occurs at birth because the defect is in the embryological branchial cleft. It is rare, and accounts for 8% of the branchial cleft anomalies, which is why it is sometimes misdiagnosed.


Diagnosis

The patient presents with non-healing ulcers of the neck and one of the external auditory canals. Diagnosis is confirmed by injecting
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. As a medication, it is mainly used to treat methemoglobinemia. It has previously been used for treating cyanide poisoning and urinary trac ...
dye into the neck opening, and dye coming out of the opening in the external auditory canal.
Computerized tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...
fistulogram can yield more accurate results regarding the course of the fistula.


Treatment

Treatment of collaural fistula is done by surgical exploration and excision. The fistulous track is removed with skin and cartilage. Split thickness skin grafting and stenting is done if more than 30% of the external canal's circumference has been removed. The potential complications following fistula removal surgery are facial nerve paralysis and recurrence.


References

{{reflist Diseases of the ear and mastoid process Fistulas