ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Acellular dermal matrix insertion versus fascia-anchoring suture after preauricular fistulectomy.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the efficacy and safety of acellular dermal matrix (ADM) insertion with traditional fascia-anchoring sutures for managing dead space and improving aesthetic outcomes following preauricular fistulectomy.
methodsA retrospective review was conducted on 135 ears that underwent preauricular fistulectomy performed by a single surgeon between September 2020 and December 2024. The patients were divided into two sequential cohorts: fascia-anchoring suture (n = 52) and ADM insertion (n = 83) groups. Operation time, complications (seroma and hematoma), recurrence rates, and aesthetic satisfaction (5-point Likert scale) were analyzed and compared as surgical outcomes.
resultsDemographic characteristics and excised specimen dimensions were comparable between the groups. The ADM insertion group demonstrated significantly higher aesthetic satisfaction scores (3.96 ± 0.82) compared with the fascia-anchoring suture group (3.21 ± 0.87; p < 0.001). Importantly, the proportion of patients reporting satisfaction (score ≥ 4) was significantly higher in the ADM group (69.9% vs. 36.5%; p < 0.001). The incidence of postoperative seroma or hematoma and operation time did not differ significantly between the groups. No recurrences were observed in either group, despite preoperative inflammation being present in approximately 40% of the patients in both groups.
conclusionADM insertion is a safe and effective alternative for managing soft tissue defects after preauricular fistulectomy. Compared with fascia-anchoring sutures, ADM insertion provides significantly improved patient-reported aesthetic satisfaction without increasing complication risks, making it a valuable option for patients with substantial defects.
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