PMC5831870_01
The opening of the fistula tract is seen on the root of the helical crus (a). A lower opening is visible in the postauricular crease (b).
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The lower opening in the postauricular area was surrounded by a reddish cystic lesion (Figure 1).
A CT scan with contrast shows a left rim-enhancing cyst in the postauricular crease.
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A preoperative computed tomography (CT) scan showed a left rim-enhancing cyst in the postauricular crease (Figure 2).
Surgical findings of the fistula tract. The tract and the opening in the postauricular crease (arrow) were excised (a). The fistula tract after total removal (b).
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The tract was traced anteriorly to the helical crus and a portion of helical cartilage was excised in continuity with the tract (Figure 3).
The fistula was lined with squamous epithelium, with features suggestive of a branchial cleft fistula (x100, hematoxylin and eosin stain).
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Histopathology revealed that the excised tissue was a fistula lined with squamous epithelium (Figure 4).