| Preauricular sinus and cyst | |
|---|---|
| Other names | Congenital auricular fistula, Congenital preauricular fistula, Ear pit, or a Preauricular cyst |
 | |
| Preauricular sinus on right ear | |
| Specialty |
Otorhinolaryngology 
|
Preauricular sinuses and preauricular cysts are two common congenital malformations. Each involves the external ear. The difference between them is that a cyst does not connect with the skin, but a sinus does. Frequency of preauricular sinus differs depending the population: 0.1–0.9% in the US, 0.9% in the UK, and 4–10% in Asia and parts of Africa.
Preauricular sinuses are inherited features, and frequently appear next to both ears. Preauricular sinuses can be associated with other defects that are not visible, one example being branchio-oto-renal syndrome.
Presentation
Complications
Occasionally a preauricular sinus or cyst can become infected. Most preauricular sinuses are asymptomatic, and remain untreated unless they become infected too often. Preauricular sinuses can be excised surgically, but often present a high risk of recurrence.
Causes
Preauricular sinuses and cysts result from developmental defects of the first and second pharyngeal arches. This and other ear malformations are sometimes associated with renal anomalies. In rare circumstances these pits may be seen in genetic conditions such as branchio-oto-renal syndrome; however these conditions are always concurrent with other health concerns.
Treatment
Courses of treatment typically include the following:
- Surgical excision is indicated with recurrent fistular infections, preferably after significant healing of the infection. In case of a persistent infection, infection drainage is performed during the excision operation. The operation is generally performed by an appropriately trained specialist surgeon e.g. an otolaryngologist or a specialist General Surgeon.
- The fistula can be excised as a cosmetic operation even though no infection appeared. The procedure is considered an elective operation in the absence of any associated complications.
See also
Bibliography
- Leopardi G, Chiarella G, Conti S, Cassandro E (December 2008). "Surgical treatment of recurring preauricular sinus: supra-auricular approach". Acta Otorhinolaryngologica Italica. 28 (6): 302–5. PMC 2689545. PMID 19205595.
- Kim JR, Kim DH, Kong SK, Gu PM, Hong TU, Kim BJ, Heo KW (November 2014). "Congenital periauricular fistulas: possible variants of the preauricular sinus". International Journal of Pediatric Otorhinolaryngology. 78 (11): 1843–8. doi:10.1016/j.ijporl.2014.08.005. PMID 25190621.
Further reading
- Tan T, Constantinides H, Mitchell TE (November 2005). "The preauricular sinus: A review of its aetiology, clinical presentation and management". International Journal of Pediatric Otorhinolaryngology. 69 (11): 1469–74. doi:10.1016/j.ijporl.2005.07.008. PMID 16125253.