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Case Report
The role of medical imaging in the management of a complex prehelix fistula in children: A case report
1 Faculty of Medicine, Department of Specialities, Notre Dame University of Tshumbe, Tshumbe, Sankuru, Democratic Republic of the Congo
2 ENT Department, Saint Joseph Hospital, Kinshasa, Democratic Republic of the Congo
3 Faculty of Medicine, Department of Radiology, University of Kinshasa, PO Box 834, Democratic Republic of the Congo
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Auguste Oluku Omadjela
Saint Joseph Hospital, Kinshasa,
Democratic Republic of the Congo
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Article ID: 100021Z18AO2026
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Omadjela OA, Yanda TS. The role of medical imaging in the management of a complex prehelix fistula in children: A case report. J Case Rep Images Otolaryngol 2026;5(2):1–4.ABSTRACT
Introduction: Complex prehelix fistula is an extremely common congenital malformation in children, but of course it is not always diagnosed quickly. The aim of this study was to show the added value of medical imaging for handling a complex prehelix fistula in our context.
Case Report: We report, here, a left prehelix fistula in an 11-year-old girl, seen and treated at the ear, nose, and throat (ENT) department for a small opening in front of the left helix with a swelling in front of the tragus for several years. We performed an incision and drainage of the pretragial abscess combined with antibiotic and anti-inflammatory therapy, followed by a prehelix fistulotomy (sinusectomy) without prior fistulography. The postoperative course was marked by a remission lasting approximately five months, after which several episodes of pre-tragus abscesses occurred in succession, all controlled by antibiotic therapy. Postoperative fistulography revealed a long, sinuous fistulous tract, explaining the recurrence. Magnetic resonance imaging performed one year later revealed associated brain malformations and the absence of an active fistula tract, indicating healing of the fistula without the need for reintervention.
Conclusion: The prehelix fistula is associated with a high rate of recurrence and infectious episodes. Medical imaging plays a key role in the pre- and postoperative management of the prehelix fistula. This clinical case demonstrates the value of medical imaging both for preoperative mapping and for identifying associated malformations.
Keywords: Children, Management, Medical imaging, Prehelix fistula
SUPPORTING INFORMATION
Author Contributions
Auguste Oluku Omadjela - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Stéphane Tongo Yanda - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Auguste Oluku Omadjela et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
