Learning Objectives:

Objectives: To identify the retroauricular infection occurring in patients of congenital aural stenosis (CAS) with those in first branchial cleft fistula. To reduce the misdiagnosis and make right treatments.

Design: Retrospective review.

Subjects: 105 CAS patients who underwent meatoplasty with canalplasty and/or tympanoplasty between Jan 2011 and June 2014.

Results: During the surgery, of the 105 patients, no cholesteatoma was found in 26 patients, age from 2 yr to 29 yr, the median age was 11 yr. Cholesteatoma of the external ear canal (EC) was associated in 79 patients, age from 2 yr to 45 yr, the median age was 10 yr. Of these 79 patients, 18 had retroauricular infections, age from 3 yr to 38 yr, the median age was 6 yr. Of the105 patients, 2 patients had preauricular fistula, 3 had first branchial fistula, 4 patients with retroauricular abscess were misdiagnosed as the first branchial cleft fistula. The narrow external auditory meatus, computed tomography and magnetic resonance imaging made it easier to identify the two diseases. Drainage of the abscess was done at the first stage to control the infections for both diseases. The second stage of the operation was canalplasty for those CAS with EC. While for the first branchial cleft fistula, the surgeons paid more attention to the facial nerve.

Conclusion: The retroauricular infections occurring in CAS should be identified with the first branchial cleft fistula. The canalplasty of CAS associated with EC will get a satisfactory results even complicated with severe infections.