In the article, we consider what a fistula is. This is a channel that is formed during the inflammatory process, accompanied by the formation of purulent cavities. It occurs when there is no other way out for pus, a narrow channel appears, which is covered with epithelial tissue inside. What is the danger of a fistula in a child? About it below.
Fistula on the gum
Gingival fistula in a child is an unpleasant disease. But with timely therapy, it does not cause any complications and does not affect health negatively. The causes of the gingival fistula in a baby may be local manifestations of certain diseases, for example, odontogenic chronic sinusitis, osteomyelitis and periodontitis. A tooth that has not cut through to the end can also cause the formation of a fistula in a child.
Fistulas also appear on the mucous membrane of the palatine membrane, depending on where the crown of the tooth is located. A underlying abscess or caries may be the cause. In some cases, the appearance of a fistula on the baby’s face is also observed. It also occurs in a neglected situation - when an abscess is opened spontaneously or after a defect in the integrity of the inflammatory focus by an external incision.
Features of the treatment of gingival fistula
What should parents do when they find a fistula in a child on the gum? To begin with, the most important thing is to prevent panic, eliminate solid foods from the diet and rinse the mouth with herbal decoctions to eliminate inflammation and reduce swelling. However, these are only elementary measures that will slightly alleviate the patient's condition. How is a child's gum fistula treated? You need to seek professional help from a dentist. Depending on the stage of development of the pathology, the treatment of the gingival fistula in a baby suggests several options.
Pathology therapy
At an early stage of infection, it is sufficient to use antibacterial agents to eliminate puffiness and prevent the infection process.
How to open a fistula on the gum of a child?
The therapeutic way.
With more complex forms of the disease, the doctor will clean the dental canals, eliminate pus deposits and plaque. After this, professional cleaning is carried out, and the diseased tooth is sealed.
Surgery.
If the area of ​​inflammation is too large and the tooth cannot be preserved, it remains only to remove it and cure the tissues located nearby.
A fistula may also occur on the child’s neck.
Neck education
The peculiarity of such a disease as a congenital fistula in the neck of a child depends on a genetic factor. Pathology can be prevented at the stage of pregnancy planning, if you study your genetic lineage carefully.
Fistulas appearing on the neck are divided into the following forms: lateral and median.
The middle fistula appears due to the underdevelopment of the lingual-thyroid canal, its functional abilities are still at the embryonic stage of development. Pathology is a weeping point in the middle of the neck. In some cases, it is possible to pierce a seal resembling a roller in the region of the hyoid bone.
A lateral fistula is formed due to a violation of the thymus gland, when the canal is not overgrown. The hole is a gap formed along the inner muscle edge in the clavicle. Behind the fistulous opening in rare situations, a canal is visible that goes to the tonsils or even to the arc of the sky.
The lateral and median fistulas form after a cyst breaks. Purulent-serous mucus is released from the hole as a result. This discharge does not allow the body to recover independently without medical assistance.
Causes
Such a congenital pathology as a cervical fistula in a child can manifest itself at the age of five or seven years. It is much less common to determine the dense formation in the hyoid bone in younger children. This is explained by the fact that the cyst is deep, while the cervical organs are formed incorrectly.
The median or lateral fistula occurs as a result of:
- inflammation in the upper respiratory organs;
- infections
- inflammation in the oral cavity.
When the cyst is opened at the inflammatory stage, a fistula begins to form in this area, from which an unpleasant fluid will constantly come out, which, constantly causing irritation to the fistulous course, interferes with its healing.
In a child, a cyst in some cases is combined with other genetic disorders of the neck:
- underdeveloped ear shell;
- parotid fistula ;
- deformation of the surface of the nose.
The fistula can open unexpectedly on any area of ​​the neck. In some cases, goiter or thyroid tissue, as well as growths of lymphoma, come across on its walls.
Diagnosis is based on the use of radiography by introducing a contrast medium into the fistula channel. When it is not possible to carry out a radiography, a thorough examination is carried out taking into account individual hereditary pathologies.
How is the disease treated?
When determining the exact diagnosis, a logical question arises: "Is the cervical fistula in a child treated without the intervention of a surgeon?". The answer is unequivocal in any case: it is impossible. Affected fistulous canals must be neutralized. For this purpose, anti-inflammatory treatment is used, the abscess is opened. When the inflammatory stage ends, an operation is performed.
This is a small operation carried out as planned.
The course of the fistula on the neck is completely excised with the cyst. In some cases, you need to remove the area of ​​the hyoid bone, which is adjacent to the cyst. Surgery is done under general anesthesia, the risk of complications is eliminated.
It is very important in this case not to disturb the canal and its integrity, in connection with which, with a long length, in some situations two cuts are made on the skin surface. Cuts are made around the hole.
Statistical information suggests that the intervention to remove the cervical fistula is always carried out with success, without complications. The most important thing that needs attention is possible bleeding. Small patients easily tolerate the procedure and recover quickly after treatment. Scars pass after 3-4 months, it is recommended at this time to additionally undergo an ultrasound examination. If you adhere to preventive recommendations, relapse can be avoided.
It should be noted that it is not recommended to postpone the operation. It is better to carry it out at an early age in order to avoid further trauma to the child's psyche.
Treatment of fistula in children should be comprehensive and timely.
Fistula in the ear
A fistula near the ear is localized in the auricle, being a canal that is lined with epithelium. Such a disease often manifests itself even at the birth of the baby, but it can also be a consequence of surgical complications, prolonged inflammation (including otitis media).
In infants, a congenital pathology in a quarter of cases is hereditary. It happens that the fistula is diagnosed incorrectly, it is confused with another disease, and the patient gets to the specialist already with an abscess.
The ear fistula in a child is located on the ear tragus, it is more often than a small length. The move has a blind ending. The main cause of the disease: nonunion of tubercles among themselves. However, fistulas can be with long strokes that capture the neck, middle ear and nasopharynx.
The fistula inlet near the ear is not more than a millimeter, under the skin cover the fistulous canal itself is about a centimeter (depending on the variety).
Pathology treatment
This disease is not only characterized by a poor aesthetic appearance, but also needs careful therapy and compliance with medical recommendations. With non-inflammatory and shallow fistulas, it is undesirable to apply treatment to them.
Antibiotic therapy
When the process of inflammation begins, fistulas are opened so that pus comes out. In order to alleviate the condition of the patient, it is desirable to be treated with antiseptic and antibacterial drugs. Inflamed fistulas are lubricated with Chlorhexidine and Levomekol. After the cessation of inflammation from the fistula, pus ceases to be secreted, and it closes itself until subsequent inflammation. When localizing fistulas in the ear in such a way that they cannot be reached, antibacterial treatment is prescribed that relieves the inflammatory process, and fistulas will be eliminated without additional surgical intervention.
Fistula removal operation
With relapses of purulent inflammation, surgical treatment is performed. The anterior fistulas are located near the nerves of the face, so all manipulations must be carried out very carefully. Before the appointment of the operation, the specialist will prescribe a fistulography to the patient in order to understand how deep the channel is and whether it has branches.
Fistulas of short length are split or excised by galvanic caustic. Long fistulas are excised, if the operation is unsuccessful and there is a capsule in the ear, the inflammation process starts again.
In older children, excisions are performed under stationary conditions under local anesthesia; younger children are recommended to undergo general anesthesia. The degree of surgical intervention in the child's body is determined by the stage of the disease and complications. If the inflammation is single and acute, then the skin is cut, the exposed cavity is drained.
Serious surgical procedures should preferably be performed one month after the inflammation has been eliminated. The wound surface after surgery is treated with antiseptic drugs. When pain occurs, it is advisable for the child to take an antibacterial course and give pain medication. After surgery, recovery is quick.
The surgeon must have a very high qualification, otherwise the scars will hide the fistulas after the operation, and the second operation will be impossible.
We examined what fistula, types of pathology and treatment methods are.