In the article we will 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 outlet for pus, a narrow channel appears, which is covered with epithelial tissue inside. How dangerous is a fistula in a child? More on that below.
Fistula on gums
Gingival fistula in a child is an unpleasant disease. But with timely therapy, it does not cause any complications and does not affect he alth negatively. The causes of gingival fistula in a baby can be local manifestations of certain diseases, for example, odontogenic chronic sinusitis, osteomyelitis and periodontitis. A tooth that has not fully erupted can also cause a fistula to form in a child.
Fistulas also appear on the palatal mucosa, depending on where the crown of the impacted tooth is located. An abscess or caries can be the cause. In some cases, the appearance of a fistula on the face of the baby is also observed. It also occurs in runningsituations - when opening an abscess spontaneously or after a defect in the integrity of the inflammatory focus with an external incision.
Features of treatment of gingival fistula
What should parents do when a fistula is found in a child on the gum? To begin with, the most important thing is not to panic, exclude 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 gingival fistula treated in a child? You need to seek professional help from a dentist. Depending on the stage of development of the pathology, the treatment of gingival fistula in a baby involves several options.
Pathology Therapy
At an early stage of infection, it is enough to use antibacterial agents to eliminate swelling and prevent the infectious process.
How to open a fistula on the gums of a child?
Therapeutic way.
In more complex forms of the disease, the doctor will clean the dental canals, eliminate deposits of pus and plaque. After that, a professional cleaning is carried out, and the diseased tooth is sealed.
Surgery.
If the area of inflammation is too large and it is impossible to save the tooth, it remains only to remove it and cure the tissues located nearby.
There may also be a fistula in the baby's neck.
Education on the neck
The peculiarity of such a disease as a congenital fistula on the neck of a child depends ongenetic factor. Pathology can be prevented at the stage of pregnancy planning, if you carefully study your genetic pedigree.
Fistulas that appear on the neck are divided into the following forms: lateral and median.
The median 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, you can feel the seal, resembling a roller, in the area of the hyoid bone.
The lateral fistula is formed due to violation of the thymus when the canal is not overgrown. The hole is a gap formed along the inner muscular edge in the region of the clavicle. Behind the fistulous opening, in rare situations, a canal is visible that goes to the tonsils or even to the arch of the sky.
Lateral and median fistulas are formed after the breakthrough of the cyst. As a result, purulent-serous mucus is released from the hole. This discharge does not allow the body to recover on its own without medical assistance.
Reasons
Such a congenital pathology as a cervical fistula in a child can manifest itself at the age of five or seven. Much less often it is possible to determine a dense formation in the area of the hyoid bone in younger children. This is explained by the fact that the cyst is deep, while the cervical organs are formed incorrectly.
Median or lateral fistula results from:
- the process of inflammation in the upper respiratory organs;
- infections;
- inflammationin the mouth.
When a cyst is opened at the inflammatory stage, a fistula begins to form in this area, from which an unpleasant liquid will constantly come out, which, constantly irritating the fistulous tract, 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 channel can open unexpectedly on any area of the neck. In some cases, tissues of the goiter or thyroid gland, as well as growths of lymphoma, come across on its walls.
Diagnosis is based on the use of radiography by introducing a contrast agent into the canal of the fistula. When x-rays are not possible, a thorough examination is performed taking into account individual hereditary pathologies.
How the disease is 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 channels must be neutralized. For this purpose, anti-inflammatory treatment is used, the abscess is opened. When the inflammatory stage ends, surgery is performed.
This is a small operation carried out as planned.
The course of the fistula on the neck is completely excised along with the cyst. In some cases, the area of the hyoid bone that is adjacent to the cyst must also be removed. Surgery is done under general anesthesia, the risk of complications is excluded.
It is very important not to disturb the canal and its integrity, and therefore, with a large length, in some situations, two incisions are made on the skin surface. The cuts are made around the hole.
Statistical information suggests that the intervention to remove the cervical fistula is always successful, without complications. The most important thing that requires attention is possible bleeding. Small patients easily tolerate the procedure and recover quickly after therapy. Scars disappear in 3-4 months, it is recommended to undergo an additional ultrasound examination at this time. If you follow preventive recommendations, a relapse can be avoided.
It should be noted that postponing the operation is not recommended. 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 ear
A fistula near the ear is localized in the auricle area, being a canal lined with epithelium. Such a disease often manifests itself even at the birth of a baby, but it can also be the result of surgical complications, prolonged inflammation (including otitis media).
In infants, 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 goes tospecialist already with an abscess.
The ear fistula in a child is located on the ear tragus, it is most often of a small length. The move has a blind ending. The main reason for the appearance of the disease: nonunion between the tubercles. However, fistulas can be long tracts that involve the neck, middle ear and nasopharynx.
The inlet of the fistula near the ear is no more than a millimeter, under the cover of the skin the fistulous canal itself is about a centimeter (depending on the variety).
Treatment of pathology
This disease not only has a poor aesthetic appearance, but also needs careful therapy and compliance with medical recommendations. For non-inflamed and shallow fistulas, it is undesirable to apply treatment to them.
Antibacterial therapy
When the process of inflammation begins, fistulas are opened so that pus comes out from there. In order to alleviate the patient's condition, it is desirable to be treated with antiseptic and antibacterial drugs. Inflamed fistulas are lubricated with Chlorhexidine and Levomekol. After the cessation of inflammation, pus ceases to stand out from the fistula, and it closes itself until subsequent inflammation. If the fistulas are located in the ear in such a way that they cannot be reached, an antibacterial treatment is prescribed that relieves the inflammatory process, and the fistulas will be eliminated without additional surgical intervention.
Fistula operation
In case of relapses of purulent inflammation, surgical treatment is performed. Anterior fistulas are located near the nerves of the face, so allmanipulations must be carried out very carefully. Before scheduling an operation, a specialist will prescribe a fistulography to the patient in order to understand how deep the canal is and whether it has branches.
Fistulas of small length are split or excised by galvanocaustic. Long fistulas are cut out, if the operation is unsuccessful and a capsule remains in the ear, the inflammation process begins again.
In older children, excisions are performed in a hospital under local anesthesia, younger children are recommended to do under 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 one-time and acute, then the skin is cut, the opened cavity is drained.
Serious surgical manipulations are preferably carried out a month after the inflammation has been eliminated. The wound surface after the operation is treated with antiseptic preparations. When pain occurs, it is advisable for the child to take an antibacterial course, to give painkillers. After the operation, recovery is fast.
The surgeon must be very highly qualified, otherwise the scars after the operation will hide the fistulas, and the second operation will be impossible.
We looked at what a fistula is, types of pathology and treatment methods.
