case_images: PMC9897677_01
case_images: Right (A and C) and left (B and D) auricles before (A and B) and after (C and D) surgical treatment.
case_images: cureus-0015-00000033329-i01.jpg
case_images: PMC9897677_01_cureus-0015-00000033329-i01.jpg
case_images: FIG1
case_images: Physical examination revealed bilateral sinus at the cavum conchae (Figure 1A and Figure 1B). No recurrence was found (Figure 1C and Figure 1D).
case_images: Surgical treatment of the left ear (A-D) and right ear (E-H).. A: Skin incision. B: The sinus including the skin lesions were resected. C: The cartilage of the cavum conchae was dissected. D: Skin suture.
case_images: cureus-0015-00000033329-i02.jpg
case_images: PMC9897677_01_cureus-0015-00000033329-i02.jpg
case_images: FIG2
case_images: After performing an elliptical incision around the hole (Figure 2A) and separating the surrounding tissues, the auricle cartilage could be seen (Figure 2B). The cartilage of the cavum conchae was also dissected (Figure 2C). The surgical wound was sutured using 5-0 ETHILON (ETHICON, Inc., Raritan, NJ, USA) (Figure 2D). Five months later, the same surgery was performed on the right ear as on the left ear under general anesthesia (Figure 2E-2H).
case_images: Histopathological study.. The fistula connected to the epidermis was covered with keratinized stratified squamous epithelium. Inflammatory cells were infiltrating the fistula.
case_images: cureus-0015-00000033329-i03.jpg
case_images: PMC9897677_01_cureus-0015-00000033329-i03.jpg
case_images: FIG3
case_images: Keratophagocytic multinucleated giant cells, histiocytes, and inflammatory cell infiltrates, which constituted a foreign body response to keratides, were present around the fistula (Figure 3).