Parotid fistula is a rather unpleasant formation. The danger is that in the initial stages it is quite difficult to notice. In this article we will talk about the causes, symptoms, as well as methods of treating this ailment.
Signs of illness
At its core, the parotid fistula (ICD L98.8.0) is a hole with a small diameter, which is the entrance to the subcutaneous and interstitial passages. In simple terms, the disease is a hole in the ear. In some cases, the disease does not make itself felt for many years. Indeed, small formations do not pose any threat to health, and their development is asymptomatic. Identify the parotid fistula in a child and an adult is possible only when examining the organs of hearing or during cosmetic procedures.
If the fistula threatens the health of the patient, then its symptoms are more pronounced. Key features:
- the appearance of an opening near or inside the auricle;
- the allocation of pus or secretion of white color;
- the formation of growths that look like leather tubercles;
- pain
- nausea and general weakness;
- temperature rise;
- swelling;
- tissue inflammation.
Similar symptoms indicate infection in the hole. In this case, you need to seek help from an otolaryngologist who will prescribe adequate treatment.
Localization
In most cases, a parotid fistula appears on the tragus or near the ear curl. But a hole with a small diameter can be localized within the facial facial nerve. In this case, the treatment of the disease is difficult. Through passages can sometimes form, spreading over a considerable distance and affecting neighboring organs. Cases were recorded when the fistula went into the oral cavity, nasopharynx, middle ear and labyrinth.
Causes of occurrence
The disease may appear due to a variety of factors. But they all fall into two main categories:
Congenital parotid fistula occurs due to malfunctioning of the baby in the womb. In most cases, this occurs due to various complications during pregnancy. But often, the genetic predisposition also affects the onset of the disease, because in 25% of cases the disease develops during the transmission of mutations of a recessive type.
Acquired fistula of the parotid region
This type of disease can develop at any age. Main reasons:
- mechanical damage with subsequent suppuration of the wound;
- complications after surgery;
- infection;
- complications after otitis media or other ear disease.
The size of the parotid fistula depends on the vastness of the purulent process. And with the formation of a wide opening, the risk of bacteria and microorganisms entering the ear significantly increases. This leads to frequent inflammatory processes, especially if the fistula has an exit to another part of the organ.
Diagnostics
An otolaryngologist can determine a parotid fistula. First, a specialist conducts a superficial examination, and if a disease is suspected, prescribes a pressor test. This study helps detect fistulas. After diagnosing the disease, the doctor needs to find out the length and depth of the internal course of the fistula. This can be done using fistolography. This study also shows the presence of branching strokes.
Treatment
With the congenital type of the disease, it is necessary to carefully examine the course of the disease. If it does not appear in any way and does not pose a threat to the health of the child, then therapy consists in regular treatment of the ear with disinfectants. This is necessary in order to exclude the formation of suppuration or infection. In the future, when an older child reaches, an operation to remove the fistula can be performed.
If suppuration or swelling of the surrounding tissues is observed, then a course of treatment is necessary. At the initial stage of therapy, the doctor makes a small incision on the inflammation. This is necessary in order to give a way to purulent contents. For further treatment, the patient is prescribed such drugs:
- ointment "Levomekol";
- a solution of chlorhexidine bigluconate.
After the inflammatory process stops, the opening of the fistula closes. But sometimes the course can again fester. In cases of frequent relapse, an operation to remove the fistula is prescribed.
Surgical intervention
The most effective treatment is the complete removal of the capsule and strokes of the parotid fistula. The operation in most cases is performed by the traditional method. In this case, the capsule of the fistula is opened and its purulent contents are removed. In adults and older children, excision is performed in a hospital using local anesthesia. After the operation, the patient is prescribed antibiotics and antiseptics, as well as pain medications. For external treatment, Chlorhexidine and Levomekol are used.
But recently, new methods have also been used to remove fistula: galvanocaustic and laser surgery. Thanks to such operations, the problem area is completely split, and removing the capsule and excising the strokes helps prevent relapse in the future.
Surgery is the best treatment, but only an experienced surgeon can do it. After all, near the parotid fistula there are a large number of facial nerves. And if they hurt or damage, then the facial expressions of the person will be violated, it will be impossible to correct the error. In addition, with an incorrectly performed operation, the risk of re-occurrence of fistulas increases. Relapse in this case is dangerous because the scar tissue masks the entrance to the tunnel, so a hidden purulent process develops.
Drug therapy
A similar treatment method is used if the fistula is located in inaccessible places, when it is not possible to carry out the operation. In this case, the patient is prescribed a course of antibacterial therapy. Such a treatment method allows you to stop the inflammatory process. Drug therapy is especially effective in the early stages of the disease. With proper treatment, a complete disappearance of the fistula can be achieved.
Traditional medicine recipes
Before applying this or that remedy, it is recommended to consult with your doctor. Remember that self-medication can be very dangerous. And with the wrong or inappropriate methods of therapy, instead of the desired relief, you will get a lot of complications. For the treatment of parotid fistula, you can apply such means:
- Mummy. This substance has excellent healing, anti-inflammatory and regenerative properties. To treat a fistula, dissolve a small piece of mummy in water and make lotions from this mixture.
- St. John's wort Compresses from the decoctions of this medicinal plant will help to stop the inflammatory process, as well as accelerate wound healing.
- Mix vegetable oil and vodka in equal parts. Process this affected area with this solution, put the cabbage leaf on top. A similar compress will help stretch the pus and stop the inflammatory process.
Ear fistula is a rather unpleasant disease that can significantly reduce the quality of life. And the sooner you seek the help of a doctor and begin treatment for the disease, the easier the therapy and the consequences of this disease will be. Be healthy!